UK VISA APPLICATION FORM Attach Photo Here

YOU SHOULD COMPLETE THIS FORM IF YOU WISH TO COME TO THE UK TO WORK OR LIVE

What is the main purpose of your visit to the UK? >>>> How long do you intend to stay in the UK?

Travel Dates On which date will you leave the UK?

On which date do you wish to travel to the UK? >>>>>>>>>>>

D D M M Y Y Y Y

Part 1 About You

Surname First Name Middle Name

Middle Name Mr. Mrs. Miss Sex: Male Female

Date of Birth >>>>>>>>>>>>>>>>>>>>>> Place of Birth >>>>>>>>>>>>>>>>>>>>>>

(Town/Country) /

Country of Birth >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> Nationality >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Marital Status? Single Married/Civil Partner Unmarried Partner

Divorced/Dissolved Partnership Separated Widowed/Surviving Civil Servant

Part 2 Passport Information

Enter details of the passport or travel document that you will use to travel to the UK.

Current passport or travel document number >>>>>>>>> Place of Issue

Issuing Authority >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> Date of Issue

D D M M Y Y Y Y

Date of Expiry >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> is this your first passport? Put a cross (x) in the relevant box
Yes No
D D M M Y Y Y Y
2.7 Please give details of any previous passports, covering the last 10 years, including where these passports are now.

Part 3 Your Contact Details

Your full residential address and postal code >>>>>>>>>>> How long have you lived at this address?

Home (landline) telephone number

Your mobile telephone number

Email address >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Part 4 Employment

What is your present work or job or occupation? >>>>>>>>>>>>>>

What is the name of the company or organisation you

work for

Period of Contract? >>>>>>>>>>>>>>>>>>>>>>>>>

What is your work address? >>>>>>>>>>>>>>>>>>>>>>>>> What Position or designation did they offer you?

Please, give details of any additional job(s) or occupations(s) you have previously

Part 5 Previous Applications and Travel History

Have you traveled to the UK in the last 10years? If ‘Yes’ Please provide details of
any
Put a cross (x) in the relevant box Yes No trips to the UK

Date Destination Purpose Destination

Have you traveled outside your country of residence, If ‘Yes’ Please provide details of
Excluding to the UK in the last past 10years? Yes No these trips
Put a cross (x) in the relevant box

Date Destination Purpose Destination

Have you ever been refused a visa for any country,

Including the UK? Put a cross (x) in the relevant box Yes No If ‘Yes’ Please provide full details

Date Country Reason Refere nce number (for UK)

Have you been granted any UK visas in the last 10 years?

Put a cross (x) in the relevant box Yes No If ‘Yes’ Please provide details

Date Purpose Duration Reference number

Have you been refused entry on arrival to the UK in the

Last 10 years? Put a cross (x) in the relevant box Yes No If ‘Yes’ Please provide details

Date Reason Reference number

Have you ever been deported, removed or otherwise,

Required to leave any country, including the UK in the last Yes No If ‘Yes’ Please provide details
10 years? Put a cross (x) in the relevant box
Date Country Reason Reference number (for UK)
 Do you have a UK National Insurance Number? Yes No If ‘Yes’ Please provide details
Put a cross (x) in the relevant box

National Insurance Number Reason for getting a national insurance number

Do you have any criminal conditions in any country Yes No If ‘Yes’ please provide details
(Including traffic offence)? Put a cross (x) in the relevant box
Date Country offence sentence

Part 6 Employers Information

Organisation/ Employers Name >>>>>>>>>>>>>>>>>>>>

Country >>>>>>>>>>>>>>>>>>>> City >>>>>>>>>>>>>>>>>>>> State >>>>>>>>>>>>>>>>>>>>

United Kingdom

Postal Code >>>>>>>> Job Reference Number(s) >>>>>>>>>>>>> Email Address >>>>>>>>>>>>>

Street Address

Tell us brief details about yourself?

Part 7 Declaration

I hereby apply for an entry clearance to the United Kingdom. The information I have given is complete and true to the best of my knowledge.
I also declare that the photograph submitted with this form is a true likeness of me. I confirm that if, before this application is decided, ther e
is a material change in my circumstances or new information relevant to this application becomes available, I will inform the United Kingdom
Diplomatic Mission handling my application.

I am aware that it is an offence under the Immigration Act 1971 (as amended) to make a statement which I know to be false, or not believe to be true, in
order to obtain a visa/entry clearance to the UK. I am also aware that my application will be automatically refused and I may be banned from going to the
UK for 10 years if I use a false document, lie or withhold relevant information. I may also be banned if I have breached immi gration laws in the UK. I am
further aware that should I use a false document, lie or withhold relevant information my details may be passed to law enforc ement agencies.

I declare that the documents that I have supplied with this application are genuine and the statements I ha ve made with this application are truthful.
I understand that UK Border Agency (or a trusted third party) may make reasonable checks to confirm the accuracy and authenti city of evidence I have
provided and documents I have submitted with this application. I further understand that UK Border Agency (or a trusted third party) may also make
reasonable checks on any sponsors to my application to verify statements contained in the application and establish that I wi ll comply or have complied
with the terms of any visa granted.

(Provision of Physical Data) Regulations 2006, Regulation 7(1).

I understand that UK entry clearance applications may be handled by British Missions in other locations, including outside th e country in which I have
applied for entry clearance and that this may involve the transferring of my application and supporting documents to and from another Mission. I u nderstand
that the UK Border Agency will be responsible for transferring my application and supporting documents safely. I understand in these circumstances my
application will still be handled in line with UK Border Agency published customer service standards.

I understand that all information provided by me will be processed by the UK Border Agency in accordance with the Da ta Protection Act 1998. I am aware
that the UK Border Agency is the data controller in relation to the information provided by me in this application form. I am aware that the information
I provide, including biometric data, will be treated in confidence, but it may be disclosed to other government departments, agencies, local authorities,
foreign governments, and other bodies, to enable the UK Border Agency or those bodies to perform their functions. Any disclos ures will be in accordance
with the Data Protection Act 1998. I also understand that the information provided by me may also be used for staff training purposes.
I also understand that the information provided by me, or information made available to UK Border Agency during the processin g of my application, may be
shared with my sponsor(s) or any person(s) acting on their behalf or any applicant linked to my application (for example to m y spouse / partner if we apply
for visas for a trip together) for the sole purpose of considering my application. I a m aware that if there is any information I do not want you to disclose to
them I will tell you by enclosing a letter with my supporting documentation. If such requests prevent you from making legitim ate inquiries, my application
may be refused. I declare that the information given on this form is correct to the best of my knowledge and belief. I also consent to the processing of
information provided by me by the UK Border Agency.

Applicant’s signature Date

E20304082017004
VISA APPLICATION NUMBER