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Application for Schengen Visa
This application form is free
1. Surname(s) family name(s)) FOR EMBASSY /
CONSULATE USE ONLY
2. Surname(s) at birth (earlier family name(s)) Date application :
3. First names (given names)
4. Date of birth (year-month-day) 5. ID-number (optional) File handled by :
6. Place and country of birth
Supporting documents:
7. Current nationality/ies 8. Original nationality (nationality at birth) Valid passport
Financial means
9. Sex
Male Female
10. Marital status :
Single Married Separated Divorced Widow(er) Other
Invitation
Means of transport
Health insurance
Other :
11. Father’s name 12. Mother’s name
13. Type of passport:
National passport Diplomatic passport Service passport Travel document (1951 Convention)
Alien’s passport Seaman’s passport Other travel document (please specify):
………………………………………………………………………… ………….…
14. Number of passport 15. Issued by
16. Date of issue 17. Valid until
18. If you reside in a country other than your country of origin, have you permission to return to that country?
No Yes, (number and validity) ……………….……………………………………………………
* 19. Current occupation
Visa :
* 20. Employer and employer’s address and telephone number. For students, name and address of school. Refused
Granted
Characteristics of Visa :
21. Main destination 22. Type of Visa :
Airport transit Transit Short stay
Long stay
23. Visa :
Individual Collective
LTV
A
B
C
D
D + C
24. Number of entries requested
Single entry Two entries Multiple entries
25. Duration of stay
Visa is requested for: ______ days
Number of entries :
26. Other visas (issued during the past three years) and their period of validity 1 2 Multiple
27. In the case of transit, have you an entry permit for the final country of destination?
No Yes, valid until: Issuing authority:
Valid from ………………..
To …………………………
* 28. Previous stays in this or other Schengen states Valid for :
…………………………… .
* The questions marked with * do not have to be answered by family members of EU or EEA citizens (spouse, child or dependent
ascendant). Family members of EU or EEA citizens have to present documents to prove this relationship.
Photo
Stamp embassy
Or consulate
N° 12225*01

29. Purpose of travel
Tourism Business Visit to Family or Friends Cultural/Sports Official
Other (please specify): ….……………………………………………………..
Medical reasonsFOR EMBASSY /
CONSULATE USE ONLY
* 30. Date of arrival
* 32. Border of first entry or transit route
* 31. Date of departure
33. Means of transport
*34. Name of host or company in the Schengen states and contact person in host company. If not applicable, give name
of hotel or temporary address in the Schengen states
Name Telephone and telefax
Full address e-mail address
* 35. Who is paying for your cost of travelling and for your costs of living during your stay?
Myself Host person/s Host company. (State who and how and present corresponding
documentation):………………………………………………
…………………………………………………………………………………………………………………………
……………… ………………………………….
* 36. Means of support during your stay
Cash Travellers' cheques Credit cards Accommodation Other:
Travel and/or health insurance. Valid until: ………………………………………………..
37. Spouse’s family name 38. Spouse’s family name at birth
39. Spouse’s first name 40. Spouse’s date of birth 41. Spouse’s place of birth
42. Children (Applications must be submitted separately for each passport)
Name First name
1
2
3Date of birth
43. Personal data of the EU or EEA citizen you depend on. This question should be answered only by family members of
EU or EEA citizens.
Name First Name
Date of Birth Nationality Number of passport
Family relationship :
of an EU or EEA citizen
44. I am aware of and consent to the following: any personal data concerning me which appear on this visa application form
will be supplied to the relevant authorities