Please check applicable box
For Official Use
Visa No.: _______________________________
Single Entry -
$50.00
Affix passport
Type of Visa: ____________________________
Multiple Entries -
$80.00
Picture here
Date of Issue: ____________________________
Single Entry (Rush) - $80.00
Charges: _______________________________
Multiple Entries (Rush) $110.00
Issuing Officer: ___________________________
(Pay by cash or money order.
Personal checks are not accepted)
Application for Ghana Entry Permit/Visa
Embassy of Ghana, 3512 International Drive NW - Washington DC 20008
Website:
Tel: (202) 686-4520
______________________________________________________________________________________________________
INSTRUCTIONS:
This form must be completed in duplicate and in capital letters and submitted (together with two (2) recent
1.
passport-size pictures) at least Fourteen (14) days before the intended date of departure. The processing period is five
(5) business days.
2.
Full names and addresses of references/hotel (place of stay) in Ghana should be stated (including telephone numbers,
if available).
3.
Any information stated on the form and subsequently found to be incorrect may render entry permit/visa void.
4.
Applicants applying by post/mail should provide trackable prepaid return self-addressed 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) Traveling by: □ Air □ Sea □ Land
(b) Is applicant in possession of return ticket? ____________________________ Ticket No.:_____________________
(c) Amount of Money Applicant is traveling with_________________________________________________________
Purpose of Journey: □ Business
□ Tourism
□ Employment □ Official □ Student □ Transit
6.
7.
Names & Addresses of Two (2) references or place of residence while in Ghana/ Name(s) of Hotel:
(i) ____________________________________________________________________________________________
______________________________________________________________________________________________
(ii) ____________________________________________________________________________________________
______________________________________________________________________________________________
8.
If for employment, name and 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: _______________________
NB: PLEASE ENSURE YOU ENCLOSE YOUR PASSPORT WITH YOUR APPLICATION