FEDERAL DEMOCRATIC REPUBLIC OF ETHIOPIA
Birth date: D
/Yr.______ Birth Place
Field of Study/Profession
Diplomatic Alien Others
Issue Date D._____/M._____/Yr._______ Expiry Date D.______/M.______Yr._______
Home Address: Country
Address where you will stay in Ethiopia:
Name of contact person/Hotel
Requested Visa Type:
Requested Days: 30
180 365 (More than 90 days is only for business visa)
Entries: Single Multiple (Multiple entry is only for more than 30 days)
Date of Arrival to Ethiopia
To be filled by Proxy/Guardian (for children under 18 years Old)
I, the undersigned, declare that the above-mentioned statements are true to the best of my knowledge.
Full Name & Signature
Place of Request
Incomplete visa application will not be processed.
Visa fees or any amount of money paid in excess of the required amount are not refundable.
For office use only
Date of Issue
Date of Expiry