Visa Application Form - Guyana Page 2
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2VISA IMMIGRATION SERVICE | VISA APPLICATION FORM | PAGE 2 BACK
10
. Sex
Colour of Hair
Height
Colour of Eyes
i
ii.
iii.
v.
M
F
CM
Complexion
Identification Marks
iv.
vi.
11. Marital Status
Married
Single
Separated
Divorced
Widowed
12. Have you ever applied for a Guyana Visa before? If “ Yes”:
Where
When
D
D
M
M
Y
Y
13. Who will furnish financial support?
14. With whom will you stay in Guyana?
15. The address at which you will stay in Guyana
16. What is the purpose of your visit?
17. Have you visited Guyana before?
YES
NO
18. Do you intend to work in Guyana
19. If on business, name and address of firm etc.
YES
NO
20
. Have you ever:
i
YES
NO
(a) been afflicted with contagious diseases (e.g. tuberculosis) or serious mental illness?
been arrested, convicted for any offence or crime even though subject of a pardon,
(b)
YES
NO
amnesty or other legal action?
(c) been involved in narcotic activities?
YES
NO
(d) been deported from Guyana in the last five years?
YES
NO
(e) sought to obtain a visa by misrepresentation or fraud?
YES
NO
. If yes to any of the above please give details
ii
21. WHEN ARE YOU DUE TO ARRIVE IN GUYANA?
22. HOW LONG DO YOU INTEND TO STAY?
MONTHS
DAYS
D
D
M
M
Y
Y
I certify that I have read and understood all the above questions and the
answers I have given on this form are true and correct to the best of my
knowledge and belief. I understand that possession of visa does not entitle
the bearer to enter Guyana at a port of entry if he/she is found inadmissible.
AFFIX
PASSPORT SIZED
SIGNATURE OF APPLICANT
DATE
D
D
M
M
Y
Y
PHOTOGRAPH
HERE
Note: Failure to disclose the purpose of applying for a visa or the submission of false
information will result in refusal of entry or expulsion from Guyana.
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