APPLICATION FORM FOR VISA/ENTRY PERMIT
This form must be completed in full, your application may be rejected for wrong and misleading information.
Attach your photo graph:
1. Surname (MR/MRS/MISS): Other Names:
2. Sex: Marital Status:
3a. Present Nationality: 3b. Previous Nationality:
4a. Date of Birth (day/month/year): 4b. Place of Birth:
5. Residential Address: Telephone No.:
6. Office Address: Telephone No.:
8. State what branches of the Armed Forces of your country you have served or are serving
in From to
9. Colour of Hair Colour of eyes Height
10. Visible Identification marks
11. Passport No. Date of issue Date of expiry
Place of issue issuing Government
12. Purpose of journey (please give full details)
13. Number of entries required A. Single B. Multiple :
14. Intended duration of stay
15a. Proposed date of travel (day/month/year) (15b). Mode of travel to Nigeria
16. Indicate how much money is available for your trip
17. If your reason for journey to Nigeria is for employment, state:
a) Name of Employers
b) Post to be occupied
c) Give a full description of job
18. Persons joining spouses, parents or relatives, should give full particulars of the employment of parents
or spouse in Nigeria including the address where they reside
19. How long has/have your spouse/parents been in Nigeria
20. Your intended address in Nigeria (NOT P.O. BOX)
21. Have you ever applied for a Nigerian visa before? Yes/No/
22. Where did you apply for the visa?
23. Indicate whether visa was granted or rejected
24. Give reason if visa was rejected
25. Have you ever visited Nigeria? Yes/No
26. If yes, was it for:
iii. Temporary Employment
27. State the period of these visits
and the Addresses at which you stayed
From To Address
28. How long have you lived in the country where you are applying for visa/entry permit?
29. Have you ever:
a) Been infected by any contagious disease (e.g. Tuberculosis) or suffered serious mental illness?
b) Been arrested or convicted for any offence or crime even though subject of pardon, arrested or
other such legal action? Yes No
c) Been involved in narcotic activities? Yes No
d) Been deported? Yes No if so, from which country?
e) Sought to obtain a visa by misrepresentation or fraud? Yes No
f) Tested positive for HIV/AIDS? If yes, please state status
30. Give a list of the countries you have lived in for more than a year during the last five years:
Country City Date
31. Which Countries have you visited during the last twelve (12) months:
I understand that I will be required to comply with the Immigration/Alien and other laws governing
entry of Immigration into the country for which I now apply for Visa/Entry Permit.
VISA Fees are to be paid through the Nigeria immigration Website at WWW.immigration.gov.ng. Once paid, print out the form and mail to the Embassy with a PROCESSING FEE of $30.00 in money order made out to the Embassy of Nigeria. If expedited service is required, an additional fee of $65.00 in money order made out to the Nigerian Embassy should be attached. Please attach original passport, colored passport photo showing full face on white background, letter of invitation from Nigeria and return prepaid Fedex, DHL, UPS, or Express mail, if applying by mail, DO NOT ATTACH ENVELOPE AND STAMP, your application will not be mailed back with that.
REQUIREMENTS FOR CHILDREN UNDER SIXTEEN:
Copy of birth certificate of child, 1 passport photograph, signed letter of consent by both parents and copies of the parents’ passports (bio-data page) or valid ID MUST accompany the application.