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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: [email protected]


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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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