Application For Schengen Visa Form
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1
2Stamp embassy
Or consulate
Application for Schengen Visa
This application form is free
Photo
N° 12225*01
1. Surname(s) family name(s))
F
/
OR 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
10. Marital status :
Invitation
Male
Female
Single Married Separated Divorced Widow(er)
Other
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 :
Refused
* 20. Employer and employer’s address and telephone number. For students, name and address of school.
Granted
Characteristics of Visa :
21. Main destination
22. Type of Visa :
23. Visa :
LTV
Airport transit
Transit
Short stay
Individual
Collective
A
Long stay
B
C
D
D + C
Number of entries :
24. Number of entries requested
25. Duration of stay
Single entry Two entries Multiple entries
Visa is requested for: ______ days
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?
Valid from ………………..
No Yes , valid until:
Issuing authority:
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.
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