Nigeria Temporary Work Permit Visa Application Template Page 3
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1
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3Nigeria Visa Services
VISA ORDER
Tel: 0845 224 9482
Office 508, 5th Floor
The Vista Centre,
Email:
50 Salisbury Rd
FORM
Web:
Hounslow, Middlesex
TW4 6JQ
CONTACT DETAILS
Name:
Home Tel No:
Mobile Tel No:
Return Postal Address:
Email Address:
TRIP START
NAME ON PASSPORT
PASSPORT NO.
EXPIRY DATE
DATE OF BIRTH
DURATION
DATE
1
2
3
4
DELIVERY OPTIONS – PLEASE TICK
I Have Enclosed a Pre-Paid Special Delivery S.A.E
Courier Delivery within M25
Royal Mail Special Delivery
VISA AND SERVICE TYPE – PLEASE TICK
Destination – Please select
Visa Type
Visa Type
Visa Type
Visa Type
Nigeria
Business
Tourist
TWP
STR
METHODS OF PAYMENT
For Card Payments Please Complete the Details Below. Note that there is a 3.9% service charge on the Total Amount for credit card payments.
CARD DETAILS
Card Number
Issue
Security No.
Card Type
Valid From
Expiry Date
Number
(3 digits back of card)
e.g. Switch/Visa
Name on Card
Registered Card Address
I have read and agree with ‘Rapid Visas’ Terms and Conditions as described on the company website.
I hereby authorise Rapid Visas Ltd to charge a variable amount to my credit/debit card to cover the costs as detailed on the website.
As a Visa company, we make every effort to deliver the correct information to the embassy on time, but cannot guarantee the time taken by the
embassy for visa processing and issuance. Rapid Visas Ltd cannot be held liable for any delays or losses as a result of the Embassy, Royal Mail or
Courier service. Unless otherwise stated all deliveries will be made using Royal Mail special delivery.
Signature:
Print Name:
Date:
/
/
CHECKLIST:
Please ensure that you have attached the following:
Completed Embassy Application Form
Completed Rapid Visa Order Form
Necessary Fees
Passports
Passport Photos
Additional Documents if requested
Please send all information by special delivery to our office at: Nigeria Visa Services, Office 508, 5th Floor, The Vista Centre,
50 Salisbury Rd, Hounslow, Middlesex, TW4 6JQ
Tel: 0845 224 9482 Email: Web:
Rapid Visas Ltd Company Reg No. 6400012, VAT 945 4149 10
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