Application For Visa - Republic Of Namibia Page 2
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1
2
3
4NOTE: COMPLETE ONLY PART A OR B
(A) HOLIDAY / BUSINESS / WORK / TRANSIT / VISA
1. Intended date and port of arrival in Namibia:
2. (a) What is the purpose of you visit?
(b) if it is for business purposes, explain in detail the nature of business:
(c) Duration of intended visit (Number of days, weeks or months)
3. Places to be visited in Namibia (full address, including telephone number must be provided)
4. If the purpose of your visit is for medical treatment, please provide the following information:
(a) Name of doctor, hospital or clinic you will visit:
(b) Who will pay your medical expenses and hospital fees:
(c) If you are liable for the expenses and fees above, state amount of funds available:
5. Proposed residential address in Namibia:
Telephone no.: (
)
6. Names and addresses of relatives in Namibia:
Name
Address and Telephone number
Relationship
(a)
(b)
7. Date of last visit, if any, to Namibia:
8. Do you contribute professionally or otherwise to publications, radio, television or films? If so, give details:
9. (a) Destination after leaving Namibia:
(b) Mode of travel to destination:
(c) Intended date and port of departure:
(d) Is your entry to that destination assured, e.g. do you hold a visa or a permit for permanent or temporary residence? (Proof to be submitted)
10. Reasons for travelling through Namibia:
(B) RETURN VISA
IMPORTANT
An applicant has to:
(i) produce his or her passport or travel document; and
(ii) submit proof of his or her right of residence in Namibia if not endorsed in his or her passport.
1. (a) Kind of Permit and number:
(b) Date of departure:
(c) Expected date of return:
2. Particulars of Residence in Namibia:
Periods of residence in Namibia
Date of first entry
Port of entry
From
To
3. Countries to which you will be travelling:
(a)
(b)
(c)
(d)
4.
Purpose of journey (explain fully):
I solemnly declare that the above particulars given by me are true in substance and in fact and that I fully understand the meaning thereof.
Date:
Signature:
(N.B. Only the signature of the applicant will be accepted)
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Parent category: Business