Application Form For Schengen Visa (English/esperanto)

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Application for Schengen Visa
ganacxadi Sengenis vizis misaRebad
PHOTO
This application form is free
es anketa ufasoa
1. Surname (Family name) (x)
For official use only
gvari
ivseba sakonsulo
ganyofilebis mier
2. Surname at birth (Former family name(s)) (x)
qaliSvilobis (winandeli) gvari
Date of application:
3. First name(s) (Given name.(s))
(x)
saxeli/saxelebi
4. Date of birth (day-month-year)
5. Place of birth
7. Current nationality
Visa application number:
dabadebis TariRi (dRe-
dabadebis adgili
amJamindeli moqalaqeoba
Tve-weli)
Application lodged at
6. Country of birth
Nationality at birth, if different:
 Embassy/consulate
dabadebis qveyana
moqalaqeoba dabadebisas, Tu
 CAC
sxva iyo
 Service provider
Commercial intermediary
 Border
8. Sex /sqesi
9. Marital status /ojaxuri mdgomareoba
Name:
 Single
Married
 Separated
dauqorwinebeli
daqorwinebuli
ganSorebuli
 Male
 Other
mamrobiTi
 Divorced
Widow(er)
 Other (please specify)
File handled by:
ganqorwinebuli
qvrivi
sxva (miuTiTeT)
 Female
mdedrobiTi
Supporting documents:
10. In the case of minors: Surname, first name, address (if different from applicant's) and nationality of
parental authority/legal guardian
 Travel document
arasrulwlovanebis SemTxvevaSi: gvari, saxeli, misamarTi (Tu gansxvavebulia
ganmcxadeblis misamarTisagan) da mSoblis/meurvis moqalaqeoba
 Means of subsistence
 Invitation
 Means of transport
11. National identity number, where applicable
 TMI
piradi nomeri, aseTis arsebobis SemTxvevaSi
 Other:
12. Type of travel document / samgzavro dokumentis tipi
Visa decision:
 Ordinary passport
Diplomatic passport
 Service passport
Cveulebrivi pasporti
diplomatiuri pasporti
samsaxurebrivi pasporti
Refused
 Official passport
Special passport
 Other travel document (please specify)
Issued:
oficialuri pasporti
specialuri pasporti sxva samgzavro sabuTi (miuTiTeT)
A
C
13. Number of travel
14. Date of issue
15. Valid until
16. Issued by
gacemis
moqmedebis
gamcemi organo
document samgzavro
LTV
TariRi
vada
dokumentis nomeri
 Valid
From ................................
17. Applicant's home address and e-mail address
Telephone number(s)
Until ................................
ganmcxadeblis sacxovrebeli misamarTi da eleqtronuli
telefonis
fosta
nomeri/nomrebi
Number of entries:
 1  2  Multiple
Number of days:
1
No logo is required for Norway, Iceland and Switzerland.
norvegiis, islandiisa da SveicariisaTvis logo saWiro ar aris.

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