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EMBASSY OF THE REPUBLIC OF GUYANA

2490 Tracy Place NW, Washington DC 20008
Telephone: 202-265-6900, Fax: 202-232-1297

Email: guyanaembassydc@verizon.net


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GUYANA IMMIGRATION SERVICE VISA APPLICATION FORM

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1. Surname (as in passport)..................................................
2. First and Middle Names (as in passport)..................................................
3. Other Names (Maiden, Professional, Alias, etc)..................................................
4. Date and place of Birth..................................................
5. Nationality..................................................
6.(a) Passport No..................................................
(b) Date and Place issued..................................................
(c) Date Passport Expires..................................................
7. Home Address (in full)..................................................
8.(a) Telephone No..................................................
(b) How Long Resident..................................................
9.(a) Name and address of Employer..................................................
(b) Telephone No..................................................
10. Present Occupation (if retired, past occupation)..................................................
11.(a) Sex..................................................
(b) Colour of hair..................................................
(c) Height..................................................
(d) Colour of Eyes..................................................
(e) Complexion..................................................
(f) Marks of Identification..................................................
12. Marital Status: (Place X )(a) Married..................................................
(b) Single..................................................
(c) Widowed..................................................
(d) Divorced..................................................
(e) Separated..................................................
13. Have you ever applied for a Guyana visa before?
If yes: (a) Where?
..................................................
(b) When?..................................................
(c) Type..................................................
(d) Was visa issued..................................................
14. Who will furnish financial support?..................................................
15. (a) With whom will you stay in Guyana?..................................................
(b) Address of your host in Guyana..................................................
16. What is the purpose of your visit?..................................................
17. Have you ever visited Guyana before?..................................................
18. Do you intend to work in Guyana?..................................................
19. If on business, name and address of firm etc...................................................
20. Have you ever:(a) been afflicted with contagious diseases
(e.g., Tuberculosis) or has suffered serious mental illness?
..................................................
(b) been arrested, convicted for any offence or crime even though subject of a pardon, amnesty, or any other such legal action?..................................................
(c) been involved in narcotic activities?..................................................
(d) been deported from Guyana within the last five (5) years?..................................................
(e) Caught trying to obtain a visa by misrepresentation or fraud?..................................................
21. When are due to arrive in Guyana?..................................................
22. How long do you intent to stay?..................................................
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