Visa Application

Application for Schengen Visa

This application form is free

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1. Surname (Family name) (x)

FOR OFFICIAL USE ONLY

2. Surname at birth (Former family name(s)) (x)

Date of application:

Visa application number: 3. First name(s) (Given name(s)) (x) Application lodged at 4. Date of birth (day-month-year) 5. Place of birth 7.Current nationality □ Embassy/consulate □ CAC □ Service provider □ Commercial intermediary □ Border Name:

6. Country of birth

Nationality at birth, if different:

8. Sex □ Male □ Female

9. Marital status □ Single □ Married □ Separated □ Divorced □ Widow(er) □ Other (please specify)

□ Other File handled by:

10. In the case of minors: Surname, first name, address (if different from applicant's) and nationality of parental authority/legal guardian

Supporting documents: □ Travel document □ Means of subsistence □ Invitation □ Means of transport □ TMI □ Other: Visa decision: □ Refused □ Issued: □A □C □ VTL □ Valid: From Until Number of entries: 18. Residence in a country other than the country of current nationality □ 1 □ 2 □ Multiple □ No □ Yes. Residence permit or equivalent ………………… No. …………………….. Valid until * 19. Current occupation Number of days:

11. National identity number, where applicable

12. Type of travel document □ Ordinary passport □ Diplomatic passport □ Service passport □ Official passport □ Special passport □ Other travel document (please specify) 13. Number of travel document 14. Date of issue 15. Valid until 16. Issued by

17. Applicant's home address and e-mail address

Telephone number(s)

* The fields marked with * shall not be filled in by family members of EU, EEA or CH citizens (spouse, child or dependent ascendant) while exercising their right to free movement. Family members of EU, EEA or CH citizens shall present documents to prove this relationship and fill in fields no 34 and 35. (x) Fields 1-3 shall be filled in in accordance with the data in the travel document.

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