Application for Schengen Visa
PHOTO
This application form is free
يكبٌ انصٕسة انشخصٛت
ٍ
ــــــ
غ ـ
ـــــ
ُؽهت رؤشٛشح ش
ْزِ االسزًبسح يجبَٛخ
اسى انؼبئهخ
1 -
F
1. Surname (Family name) (x)
OR OFFICIAL USE ONLY
اسى انؼبئهخ ػُذ انٕالدح
2 -
Date of application:
2. Surname at birth (Former family name(s)) (x)
Visa application number:
االسى األٔل
3 -
3. First name(s) (Given name(s)) (x)
Application lodged at
□ Embassy/consulate
ربسٚخ انًٛالد
4 -
يكبٌ انًٛالد
انجُسٛخ انذبنٛخ
7 -
5 -
4. Date of birth
5. Place of birth
7.Current nationality
□ CAC
)
انسُخ
-
انشٓش
-
انٕٛو
(
(day-month-year)
□ Service provider
□ Commercial intermediary
ثهذ انًٛالد
6 -
انجُسٛخ ػُذ انٕالدح
6. Country of birth
Nationality at birth,
□ Border
الف
فٙ دبل االخز
if different:
Name:
انجُس
انذبنخ االجزًبػٛخ
9 -
8 -
9. Marital status
8. Sex
□ Other
ركش
□
□ Male
□
□
/ ح
أػضة
□ Single
□ Married
/ ح
يزضٔط
ٗأَث
□
□ Female
File handled by:
/ ح
يُفظم
□
□
/ ح
يطهك
□ Separated □ Divorced
)
دذد
(
ٖأخش
□
□
□ Widow(er) □ Other (please specify)
/ ح
أسيم
Supporting documents:
ٍػ
ٚخزهف
فٙ دبل
(
ٌٚزكش اسى انؼبئهخ ٔ االسى األٔل ٔ انؼُٕا
:
فٙ دبل انمظش
-
10
10. In the case of minors: Surname, first name, address
□ Travel document
ٙٔنٙ األيش أٔ انٕط
/
انجٓخ
/
ٍٚٔ جُسٛخ انٕانذ
)
يزمذو انطهت
(if different from applicant's) and nationality of parental
□ Means of subsistence
authority/legal guardian
□ Invitation
□ Means of transport
□ TMI
□ Other:
سلى ثطبلخ انٕٓٚخ انشخظٛخ انًسزخذيخ
-
11
11. National identity number, where applicable
Visa decision:
□ Refused
َٕع ٔصٛمخ انسفش
-
12
12. Type of travel document
□ Issued:
□ Ordinary passport
□ Diplomatic passport
ٙ□ جٕاص سفش دثهٕيبس
٘□ جٕاص سفش ػبد
□ A
□ C
□ Service passport
□ Official passport □ Special passport
□ جٕاص سسًٙ □ جٕاص خبص
□ جٕاص خبص نًًٓخ
□ VTL
)
ٚشجٗ انزذذٚذ
(
ٖيسزُذاد سفش أخش
□ Other travel document (please specify)
□
□ Valid:
سلى ٔصٛمخ انسفش
-
13
ربسٚخ اإلطذاس
-
14
طبنذخ نغبٚخ
-
15
ٍطبدسح ػ
-
16
13. Number of
14. Date of issue
15. Valid until
16. Issued by
From
travel document
Until
Number of entries:
:
َٙٔنكزش
انؼُٕاٌ انذائى نطبنت انزؤشٛشح ٔ ػُٕاَّ اال
-
17
ْبرف
17. Applicant's home address and e-mail address
Telephone number(s)
□ 1 □ 2 □ Multiple
Number of days:
:
فٙ غٛش ثهذ انجُسٛخ
اإللبيخ
ٌػُٕا
-
18
18. Residence in a country other than the country of current nationality
□ No
□ ال
□ Yes. Residence permit or equivalent …………………………. No. …………………………… Valid until………………………..
.....
.....................................
طبنذخ نغبٚخ
..
.................................
:
سلًٓب
.
....................
اإللبيخ
سخظخ
:
َؼى
□
......
................
..................
بنٛخ
انٕظٛفخ انذ
-
19
*
* 19. Current occupation
* The fields marked with * shall not be filled in by family members of EU, EEA or CH citizens (spouse, child or dependent ascendant) while exercising their right to
free movement. Family members of EU, EEA or CH citizens shall present documents to prove this relationship and fill in fields no 34 and 35.
(x) Fields 1-3 shall be filled in accordance with the data in the travel document.
.
ٚجب أٌ حعبأ طبمب نهًعهٕيبث انًذَٔت بٕثٛمت انسفش
3
إنٗ انحمم
1
يٍ انحمم
ش نٛس عهٛٓى
انهزٍٚ لذ ٚسبفشٔا يسخعًهٍٛ حمٓى ببنخجٕال انح
)
األصٔاج، األٔالد أٔ األلشببء األكبش سُب يُّ ٔ يخكفم بٓى
(
٘ألشببء يٕاطُٕ االححبد األٔسٔبٙ ٔ انُطبق االلخصبد٘ األٔسٔبٙ أٔ االححبد انسٕٚسش
*
.
33
ٔ
33
بئت انحمهٍٛ سلى
عهٗ ألشببء يٕاطُٕ االححبد األٔسٔبٙ ٔ انُطبق االلخصبد٘ األٔسٔبٙ أٔ االححبد انسٕٚسش٘ حمذٚى انًسخُذاث انز٘ حثبج ْزِ انمشابت ٔ حع
.
حعبئت انفشاغبث انًؤششة بُجًت