Bi Form 2014-00-002 - Consolidated General Application Form
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2BI FORM 2014-00-002 Rev 0
This document may be reproduced and is NOT FOR SALE
CONSOLIDATED GENERAL APPLICATION FORM
FOR NON-IMMIGRANT VISA, SPECIAL WORK PERMIT AND
PROVISIONAL WORK PERMIT
[EXCEPT STUDENT VISA AND SSP]
I
. APPLICATION INFORMATION
Present Immigration Status
Attach your 2x2 colored photograph
with white background using
Nature of Application
permanent glue in the
Conversion
Extension
Inclusion
Permit
photograph box.
Type of Visa/Permit Application
The photograph must be taken
Number of Months/Years Applied For
within the last three (3) months
3 Years
3 Months
1 Year
2 Years
from the date of application.
Method of Application
A scanned photograph is not
Personal
Authorized Representative
allowed. A photograph of the
BI Accreditation Number
applicant wearing eyewear (i.e.
sunglasses, colored contact lenses,
Name of Authorized Representative [Last Name, First/Given Name, Middle Name]
etc.) or headwear is not acceptable.
Position in the Company/Institution
II. APPLICANT’S TRAVEL INFORMATION
Passport Number
Date of Latest Arrival [DD-MMM-YYYY e.g. 01 JAN 1990]
Expiry Date/Valid Until [DD-MMM-YYYY e.g. 01 JAN 1990]
Flight Number
Place of Issuance
Last Day of Authorized Stay [DD-MMM-YYYY e.g. 01 JAN 1990]
III. APPLICANT’S PERSONAL INFORMATION
Last Name
First/Given Name
Middle Name
Other Name(s)/Alias(es)
1
2
Date of Birth [DD-MMM-YYYY e.g. 01 JAN 1990]
Gender
Country of Birth
M
F
Citizenship/Nationality
Civil Status
Single
Married
Annulled
Height [cm]
Weight [kg]
Separated
Widowed
Divorced
Profession/Occupation
Contact Number(s) in the Philippines
Email Address
Landline
Mobile
Residential Address in the Philippines
Residential Address Abroad
House/Unit No., Street, Subdivision/Village
House/Unit No., Street, Subdivision/Village
Barangay, Municipality/City
City, State
Province, Zip Code
Country, Zip Code
Name of Spouse [Last Name, First/Given Name, Middle Name]
Other Name(s)/Alias(es)
1
2
Name(s) of Child(ren) and Date(s) of Birth [Last Name, First/Given Name, Middle Name]
1
Date of Birth [DD-MMM-YYYY e.g. 01 JAN 1990]
Last Name, First/Given Name, Middle Name
2
Date of Birth [DD-MMM-YYYY e.g. 01 JAN 1990]
Note: If the applicant has more than two (2) children, use BI Form 2014-00-005 Rev 0
APPLICANT’S ACR I-CARD CLAIM STUB
Applicant’s Name [Last Name, First/Given Name, Middle Name (Please leave a box after each name)]
ACR Number
Visa Type
[IF THE ACR I-CARD IS CLAIMED BY AN AUTHORIZED REPRESENTATIVE, PLEASE SEE REVERSE SIDE FOR INSTRUCTIONS.]
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