FRENCH REPUBLIC
IDENTITY
LONG-STAY VISA APPLICATION FORM
PHOTOGRAPH
This application form is free
EMBASSY OR CONSULATE STAMP
BOX FOR VISA NUMBER STICKER
1. Surname (Family name)
For official use only
2. Former surname(s)
Application date:
3. First name(s)
4. Date of birth (day-month-year)
5. Place of birth
7. Current nationality
Application number:
6. Country of birth
Nationality at birth, if different:
Processing officer(s):
8. Sex
9. Marital status
Male
Female
Single
Married
Separated
Divorced
Widow(er)
Other (please specify)
Marginal entries
10. For minors: Surname, first name, address (if different from applicant's) and nationality of parental authority / legal guardian
11. National identity number, where applicable:
12. Type of travel document
Diplomatic passport
Service passport
Official passport
Special passport
Ordinary passport
Other travel document (please specify):
……………………………………………………………………………….
13. Number of travel document
14. Date of issue (DD/MM/YY)
15. Valid until (DD/MM/YY)
16. Issued by
17. Applicant's home address (no., street, city, postcode, country)
18. Email address
19. Telephone number(s)
20. If you are resident in a country other than the country of current nationality, please state:
Number of residence permit
Date of issue
Valid until
21. Current occupation
22. Employer (employer's address, email and telephone number) - For students, name and address of educational institution
OFFICIAL DECISION
23. I request a visa for the following purpose:
Date:
Employment
Studies
Training period/education
Marriage
Medical reasons
Family stay
Private stay/Visitor
Re-entry visa
GRANTED
Official taking up of duties
Other (please specify):
…………………………………………………………
REFUSED
24. Name, address, email address and telephone number in France of inviting employer / host institution / family member, etc.
25. What will be your address in France during your stay?