THE EMBASSY OF THE UNITED REPUBLIC OF TANZANIA
FOR OFFICIAL USE ONLY
GRR NO.___________________
VISA NO.___________________
Ref. NO.____________________
1232 22nd St. NW, Washington DC, 20037
Tel. (202) 939-6125 and (202) 884-1080 Fax (202) 797-7408
VISA APPLICATION FORM |
2 Passport Size |
(Visa Regulations on the next page) |
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Photograph |
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Size: 2x2 |
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Do not paste or |
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staple |
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1.Surname or Family Name (Mr./Mrs./Miss/Ms/Dr./Prof.)___________________________________
First Names in Full_______________________________________________________________
Former or Maiden Name (if different from above) _______________________________________
2.Date of Birth (DD/MM/YY)_______________________________________Sex (M/F)___________
3.Place of Birth____________________________Country of Birth___________________________
Current Nationality (State if Dual Nationality) ___________________________________________
Nationality at Birth________________________________________________________________
4. Marital Status (Mark): Single Married Divorced Widowed Legally Separated.
5.Passport No _________________Date Issued ______________Valid Until ___________________
Issued At ___________________Issuing Authority______________________________________
6.Profession/Occupation_____________________________________________________________
Employer Address: _______________________________________________________________
7.Current Address__________________________________________________________________
Tel.__________________Fax__________________E-mail________________________________
8.Name of Travel Agent/Tour Operator__________________________________________________
9.Contact Person(s) in Tanzania_______________________________________________________
Address_________________________________________________________________________
10.Date of Entry___________________________Depature Date______________________________
Duration of Stay_________________________ (Max. 90 Days) |
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Type of Visa Requested |
Travel Visa |
Transit Visa |
11. Purpose of visit
Leisure, Holiday Visiting friends, relatives Mission
Meeting, Conference
Other Business
Study
Transit
Health Treatment
Various
Diplomatic
Official
Same day visitor
12. |
Requested Number of Entries: |
Single |
Double |
Multiple. |
13. |
In Case Of Transit: Do you have an Entry Permit for the Final Country of Destination? |
No Yes Valid Until: |
14.Budget Available For Your Stay_________________________________
15.I Hereby Declare That The Information Stated Above Is True And Correct :
Signature of Applicant___________________________________________Date________________________________