Application For Ghana Entry Permit/visa - Embassy Of Ghana, Washington Dc
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1
2Application for Ghana Entry Permit/Visa
Embassy of Ghana Washington DC.
RUSH SERVICE
For Official Use Only
Visa No.:
Attach recent
Type of Visa:
passport size
photograph here
Date of Issue:
Issuing Officer:
Charges:
FILL WITH BLACK INK ONLY
Single Entry Rush $100.00
The form must be completed in block/capital
letters and submitted together with two(2)
Multiple Entry Rush $200.00
recent passport size photographs.
NO PERSONAL CHECKS
1. Personal Information
2. Passport Information
a. Surname /Last Name
a. Passport Number
b. Date of Issue
b. First Name(s)
c. Middle Name
c. Place of Issue
e. Date of Expiry
d. Previous Name (if applicable)
3. Name and Address of Employer/School (USA)
e. Date of Birth
f. Place of Birth
a. Profession/Occupation
g. Nationality
h. Former Nationality (if any)
NOTE:
If retired or currently unemployed, please state the
address and telephone number of last/previous
4. Residential Address
employer.
a. Street/ Mailing Address:
b. Street/Mailing Address:
b. City:
c. State d. Zip Code:
c. City
d. State:
e. Zip Code:
e. Home Phone No.:
f. Cell Phone No.:
f. Telephone Number:
g. Emergency Contact Person: (Full Name)
Your Email Address
h. Contact Person's Phone No.
i. Relationship
Applicant's intended date of travel
Is applicant in possesion of roundtrip
ticket?
Amount of money Applicant is travelling
If (yes) Indicate ticket number:
with
Traveling by:
Air
Sea
Land
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Parent category: Business