Republic Of Sierra Leone Visa Application Form
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1Tel: (202) 939-9261/9262
EMBASSY OF SIERRA LEONE
Fax: (202) 483-1793
1701 Nineteenth Street, NW
Washington D.C. 20009
VISA APPLICATION FORM
VISA APPLICATION FOR OTHER NATIONALS (SIX MONTHS [] ONE YEAR [])
THREE YEARS VISA FOR AMERICAN PASSPORTS ONLY []
LAST NAME___________________FIRST NAME___________________MIDDLE NAME________________
SEX: __________ MARITAL STATUS: _______________________ PHONE NO._________________________
HOME ADDRESS: STREET: ___________________________________________________________________
CITY: ____________________________________ STATE: _______________
ZIP CODE:_______________
EMAIL ADDRESS (Required) ___________________________________________________________________
Date of Birth [DATE: _ _ _ _] [MONTH IN WORDS: ___________________________] [YEAR: _ _ _ _ _ _ ]
Place of Birth: TOWN________________________ COUNTRY________________________________________
PARTICULARS OF PASSPORT
Passport Number: ______________________ Date of Issue: _ _ /_ _ /_ _ _ _ Date of Expiration: _ _ /_ _ /_ _ _ _
Country of Issue: ________________________________________
Passport Type: _______________________
Nationality: ___________________________________________________________________________________
PURPOSE OF VISIT: __________________________________________________________________________
PROPOSED DATE OF ARRIVAL: _ _ /_ _ /_ _ _ _
DURATION OF STAY: _________________________
NAME OF REFERREE IN SIERRA LEONE: ___________________________ PHONE NO._______________
PROPOSED ADDRESS: ________________________________________________________________________
Applicant Signature: ____________________________________
Date; ________________________________
REQUIREMENTS:
1.
One Passport Size Photo
2.
Copy of Birth Certificate for Minors (0 -16years)
3.
Sign and Notarize Application form for Minors (0 – 16 years)
4.
Fee of $160.00 (Additional $50.00 for expedited process) MONEY ORDER ONLY
5.
Prepaid Self-addressed Envelope (Priority/Next Day Delivery)
FOR OFFICIAL USE ONLY
Approving Officer: __________________________ Signature: _________________ Date: _ _ /_ _ /_ _ _ _
Fee: ______________
VISA No.______________________
General Receipt No.__________________
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