Official Visa Application For Un Employees Form
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1משרד החוץ
MINISTRY OF FOREIGN AFFAIRS
ירושלים
JERUSALEM
Official Visa Application For UN Employees
Applications with missing details will be returned without processing
Surname _______________________
Maiden Name ________________________
First Name _____________________
Father's Name ________________________
Place of Birth ___________________
Date of Birth _________________________
Day
Month
Year
Personal Status: Single
Married
Divorced Widow(er)
Citizenship ___________________________ Previous Citizenship _______________
Permanent Residence ____________________________________________________
Country
City
Street
No.
Permanent office address in Israel/PA _______________________________________
City
Street
No.
UNLP/ Passport No. ____________________
Diplomatic Service Special Official National
Issued at _____________on____________ Valid until _________________________
Name and Address of Employer or Business Contact in Israel: ___________________
_____________________________________________________________________
Applicant's official position: ______________________________________________
Name of UN employer: __________________________________________________
Name of Predecessor in said position: _______________________________________
Actual location of activity: ________________________________________________
If not replacing an existing UN employee, please specify the purpose of entry into
Israel, including the name and location of the relevant project or activity: __________
_____________________________________________________________________
If for the purpose of short term project:
Name and place of project: ________________________________________________
Date of beginning of duty: __________________Port of Entry:____________________
Predicted termination of duty: ______________________________________________
Accompanied by: ________________________________________________________
Dates of Previous Stays in Israel: ____________________________________________
Note: If the applicant or one of his immediate family members (parents, spouse, children)
is (or was) a resident or a citizen of Israel or the Palestinian Authority, please state the name
and Identity number: _____________________________________________________
Applicant's Signature
Date
Place
02-5303111
'טל
91035
, ירושלים
3013
., ת.ד
9
שד' יצחק רבין
9 Shderot Yitzhak Rabin, P.O.Box 3013, Jerusalem, 91035 Tel: 972-2-5303111
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