Application Form For Ghana Entry Permit Visa
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1FOR
O FFICIAL
U SE
PLEASE CHECK ONE:
Visa No. ____________________________________
Single Entry:
AFFIX
PASSPORT
Type of Visa _________________________________
Multiple Entry:
PICTURE
Date of Issue ________________________________
HERE
Single Entry (RUSH):
Charges ____________________________________
Multiple Entry (RUSH):
Signature of Issuing Officer________________________
Application for Ghana Entry Permit/Visa
GHANA CONSULATE, NEW YORK
th
19 East 47
Street - New York, NY 10017
Tel: (212) 832-1300
INSTRUCTIONS:
1.
This form must be in duplicate and in Capital Letters and submitted (together with Two (2) recent
Passport pictures taken at least three (3) days before the intended date of departure,
2.
Full names and addresses of two references in Ghana should be stated (including telephone numbers).
3.
Any information stated on the Form and subsequently found to be incorrect may render entry
Permit/Visa void.
4.
Applicants applying by post should provide Self Addressed Post Office Express Mail stamped
envelopes
1.
(a) Surname _____________________________ First Name(s) ___________________________________________
Previous Name (if applicable) _____________________________________________________________________
(b) Date of Birth _________________________ (c) Place of Birth _________________________________________
(d) Nationality
__________________________l
(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?
Yes
No
Ticket No.
__________________________________
(c) Financial means at Applicants disposal
______________________________________________________________
6.
Purpose of Journey: Business ___________ Tourism ___________ Employment ___________ Official ___________
7.
Name, Address and Telephone Numbers of two (2) 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 _____________________________
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