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Questionnaire
Student visa
Please fill out the questionnaire
Non Emigrant Visa Application Process Questionnaire for
Student
Work
Tourist
Personal information
1. Name Provided:
2. Other Names Used:
3. Sex: MALE – FEMALE
Male
Female
4. Marital Status:
SINGLE
MARRIED
DIVORCED
WIDOW
5. Date of birth
6. Place of Birth: CITY, STATE
7. Country/Region of Origin (Nationality):
8. Do you hold or have you held any nationality other than the one indicated above on nationality?
Yes
No
9. Are you a permanent resident of a country/region other than your country/region of origin (nationality) above
10. National Identification Number:
11. Home Address: CITY, STATE, POSTAL CODE
12. Primary Phone Number: Secondary Phone Number: Work Phone Number:
13. Do you have any additional phone numbers?
14. Email Address:
15. Do you have any additional email addresses?
Other information
16. Do you have a social media presence?
17. Passport/Travel Document Type:
REGULAR
DIPLOMATIC
18. Passport/Travel Document Number:
19. Country/Authority that Issued Passport/Travel Document:
20. City Where Issued:
21. State/Province Where Issued:
22. Country/Region Where Issued:
23. Issuance Date:
24. Expiration Date:
25. Have you ever lost a passport or had one stolen? If YES, EXPLAIN
26. Address where you will stay
27. Person/Entity Paying for Your Trip: NAME and LAST NAME, Telephone Number:, Email Address:, Relationship to You:
28. Have you ever been refused a Visa, or been refused admission to the state you are interested in to go, or withdrawn your application for admission at the port of entry?
Additional information
29. Primary Occupation:
EMPLOYER
STUDENT
30. Present Employer or School Name:
Address:
City:
State/Province:
Postal Zone/Zip Code:
Country/Region:
Work Phone Number:
Monthly Salary in Local Currency (if employed):
Briefly Describe your Duties:
31. Were you previously employed?
Yes (fill in the fields)
No (if not, go to question 32.)
Employer Name:
Employer Address:
City:
State/Province:
Postal Zone/Zip Code:
Country/Region:
Telephone Number:
Job Title:
Supervisor's Surname:
Supervisor's Given Name:
Employment Date From:
Employment Date To:
Briefly describe your duties:
32. Have you attended any educational institutions at a secondary level or above?
Yes (fill in the fields)
No (if not, go to question 33.)
Name of Institution (1):
Address of Institution:
City:
State/Province:
Postal Zone/ZIP Code:
Country/Region:
Course of Study:
Date of Attendance From:
Date of Attendance To:
33. Do you belong to a clan or tribe?
34. Provide a List of Languages You Speak:
35. Have you traveled to any countries/regions within the last five years?
36. Have you ever served in the military
Yes (fill in the fields)
No (if not, go to question 37.)
STATE
CITY
SPECILAITY
YEAR STARTED
YEAR FINISHED
37. Have you ever been arrested or convicted for any offense or crime, even though subject of a pardon, amnesty, or other similar action?
Yes (fill in the fields)
No
Type of crime
What year
Send
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AMERICA
Student visa
Work visa
Tourist visa
Great Britain
Student visa
Work visa
Tourist visa
Australia
Student visa
Work visa
Tourist visa
Canada
Student visa
Work visa
Tourist visa
Contact
About Us
info@immiconsultingmne.com
+38267376315 +38269320862