Application Form For Schengen Visa
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1
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4Application for Schengen Visa
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This application form is free
Villa 1554 - Road 5647
Block 356 - Burhama
Tel.: +973 17252424
Fax: +973 17277020
E-mail:
visti.manama@esteri.it
Website:
1. SURNAME(S) / FAMILY NAME(S)
F
O
OR
FFICE USE ONLY
2.
SURNAME(S) AT BIRTH
(earlier family names)
Il ricevente :
3.
NAME
(given name)
□
Pagato
4.
5.
DATE OF BIRTH
ID-number
(year- month-day)
(C.P.R. No.) :
□
Trasmessa
6.
PLACE AND COUNTRY OF BIRTH
□
Risposta
Data : ..................................
7.
8.
CURRENT NATIONALITY/IES
ORIGINAL NATIONALITY
(nationality at birth)
□
□
9.
10.
SEX
MARITAL STATUS
N. : .....................................
:
Single
Married
□
□
□
□
□
□
Male
Female
Separated
Divorced
Widow(er)
Other
ITALIA / MALTA
FATHER’S NAME & SURNAME
MOTHER’S NAME & SURNAME
11.
12.
Doc. a supporto:
□
□
□
13.
TYPE OF PASSPORT
National passport
Diplomatic passport
Service passport
Invito da : ............................
□
□
□
Alien’s passport
Seaman’s passport
Travel document (1951 Convention)
□
Other travel document (please specify):
PASSPORT’S NUMBER
14.
15.
.............................................
ISSUED BY
16.
17.
DATE OF ISSUE
VALID UNTIL
□
Passaporto valido
□
Mezzi economici
18.
IF YOU RESIDE IN A COUNTRY OTHER THAN YOUR COUNTRY OF ORIGIN, HAVE YOU
□
Prenotazione aerea
PERMISSION TO RETURN TO THAT COUNTRY?
□
Ass. sanitaria
□
□
NO
YES (number and validity)
□
Altro
*19.
OCCUPATION / PROFESSION
Domanda:
COMPANY’S NAME, ADDRESS, TELEPHONE NUMBERS - FOR STUDENTS : SCHOOL’S
*20.
Accettata / Rifiutata
NAME AND ADDRESS
Tipologia visto:
21.
22.
23.
MAIN DESTINATION
TYPE OF VISA
VISA
Tipo di visto:
□
□
□
□
Airport transit
Transit
Individual
Collective
□
□
□
□
□
Short stay
Long stay
A
B
C
□
□
□
24
25.
. NUMBER OF ENTRIES REQUESTED
DURATION OF STAY
C1
C2
D + C
□
□
Visa is requested for : ……… days
Single entry
Multiple entries
Numero di ingressi
26.
OTHER VISAS
AND THEIR PERIOD OF VALIDITY
(issued during the past three years)
1
2
Multi
27.
IN THE CASE OF TRANSIT, HAVE YOU AN ENTRY PERMIT FOR THE FINAL COUNTRY OF
Valido per gg. …………….
DESTINATION?
□
□
,
NO
YES
valid until:
Issuing authority:
*28.
PREVIOUS STAYS IN THIS OR OTHER SCHENGEN STATES
DAL : …………………………
29.
PURPOSE OF TRAVEL
AL …………………………….
□
□
□
□
Tourism
Business
Visit to Family or Friends
Cultural/Sports
□
□
□
Other (please specify): …..……………………………………..
Official
Medical reasons
30.
31.
DATE OF DEPARTURE (From Bahrain)
DATE OF ARRIVAL (Back in Bahrain)
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