For Official Use
Visa No. : _________________________________
Type of Visa: ______________________________
Date of Issue: _____________________________
Charges: _________________________________
Signature of Issuing Officer: __________________
APPLICATION FOR GHANA ENTRY PERMIT/VISA
MISSION _____________________________________________
INSTRUCTIONS
1. This form must be completed in
Duplicate in Capital letters and submitted (together with Four (4) recent Passport size
pictures) within at least
days before the intended date of departure
2. Full names and addresses of references in Ghana should be stated (including Telephone Number, if a available).
3. 3. Any information stated on the Form and subsequently found to be incorrect may render Entry Permit/Visa void.
4. Applications applying by post should provide Self-Addressed Stamped envelopes.
1. (a) Surname: _____________________________
First Name(s): __________________________________
Previous Name (if applicable) : ___________________________________________________________________
(b) Date of Birth : _________________________
(c) Place of Birth: _______________________________
(d) Nationality: ___________________________
(e) Former Nationality (if any): ____________________
(f) Passport No.: __________________________
(g) Date of Issue: _______________________________
(h) Place of issue: _________________________
(i) Date of expiry: ______________________________
2. Profession / Occupation : __________________________________________________________________________
3. (a) Business address & tel. no.: ______________________________________________________________________
_____________________________________________________________________________________________
(b) Residential address & tel. no.: __________________________________________________________________
_____________________________________________________________________________________________
4. Proposed date of departure for Ghana _______________________________________________________________
5. (a) Travelling by : Air _____________________ Sea _______________________ Land _________________________
(b) Is applicant in possession of return ticket? ______________________ Ticket No.: __________________________
(c) Financial means at applicant’s disposal : ____________________________________________________________
6. Purpose of journey: Business____________ Tourism ___________ Employment ___________ Official ___________
7. Name & Address of two references in Ghana:
(i) ____________________________________________________________________________________________
____________________________________________________________________________________________
(ii) ____________________________________________________________________________________________
____________________________________________________________________________________________
8. If for employment, name & address of Employer in Ghana: _______________________________________________
9. Duration of stay in Ghana: _________________________________________________________________________
10. Date of last visit to Ghana: _________________________________________________________________________
11. Applicant’s Signature: ______________________________
Date of Application: ______________________