Visa Application Form
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FEDERAL DEMOCRATIC REPUBLIC OF ETHIOPIA
Visa application
Surname
Given Names
Sex _____
Birth date: D
/M.
/Yr.______ Birth Place
Personal No.
Present Nationality
Previous Nationality
Field of Study/Profession
Institution/Organization
Passport Type:
Ordinary
Service
Diplomatic Alien Others
Passport No.__________________
Issue Date D._____/M._____/Yr._______ Expiry Date D.______/M.______Yr._______
Home Address: Country
City
Street
Postal Code
Telephone
E-Mail
Address where you will stay in Ethiopia:
Region
Zone
Sub City
Kebele
House No.
/
Name of contact person/Hotel
Telephone
Tourist
Business
Transit
Diplomatic
Service
Requested Visa Type:
Requested Days: 30
90
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)
Surname
Given Names
Telephone
I, the undersigned, declare that the above-mentioned statements are true to the best of my knowledge.
Full Name & Signature
Place of Request
Request Date
NB.
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
Visa No.
Visa Type
Amount Paid
Receipt Number
Date of Issue
Date of Expiry
Remarks
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Parent category: Business