Consulate General Of Nigeria In New York, Visa Application Form (Page 5 of 5) in pdf

Consulate General Of Nigeria In New York, Visa Application Form Page 5

22.

Have you applied for a Nigerian Visa before?

Yes_____ / No_____

23.

Where?___________________________________________________________________________________________

24.

Indicate whether visa was granted

Yes_____ / No_____

25.

Give reason if “No” to question # 24___________________________________________________________________

26.

How long have you lived in the country where you are applying for Visa/Entry Permit ________________________

27.

Have you ever:

(a)

been affiliated with any contagious disease (e.g. Tuberculosis) or suffered

serious mental illness? Yes__ / No__

(b)

been arrested or convicted for any offense or crime even though

subject of a pardon, amnesty, or other such legal action?

Yes__ / No__

(c)

been involved in narcotic activities? Yes__ / No__

(d)

been deported

Yes__ / No__

If so, from which country? ____________________________________

(e)

sought to obtain a visa by misrepresentation or fraud?

Yes__ / No__

NOTICE:

MONEY ORDER NUMBER(S) MUST BE ENTERED BELOW BEFORE SUBMITTING THIS FORM FOR

PROCESSING OTHERWISE FORMS WILL BE INCOMPLETE.

28.

US MONEY ORDER NUMBER:________________________________________________________________________

28b.

VALID EMAIL ADDRESS (PRINT):_____________________________________________________________________

I UNDERSTAND THAT I WILL BE REQUESTED TO COMPLY WITH THE IMMIGRATION / ALIEN ACTS AND OTHER

REGULATIONS GOVERNING ENTRY OF IMMIGRATION INTO THE COUNTRY FOR WHICH I NOW APPLY FOR VISA / ENTRY

PERMIT.

DATE (DAY)__________ / (MONTH)_____________ / (YEAR)______________

SIGNATURE____________________________________________________________________________

OFFICIAL USE ONLY

Consulate General Of Nigeria In New York, Visa Application Form Page 5