APPLICATION FOR SCHENGEN VISA

PHOTO THIS APPLICATION FORM IS FREE

1. Surname (Family name) (x) 2. Surname at birth (Former family name(s)) (x) 0. First name(s) (1i'en name(s)) (x) 2. Date of birth (!ay3month3year)

Father's Name:

FOR OFFICIAL USE ONLY Date of application: Visa application number:

4. 5lace of birth 6. &ountry of birth

7.&urrent nationality Nationality at birth8 if !ifferent: # # # # # pplication lo!"e! at $mbassy%consulate & & Ser'ice pro'i!er &ommercial interme!iary (or!er

9. Sex # +ale # Female

:. +arital status # Sin"le # +arrie! # Separate! # Di'orce! # ;i!o<(er) # )ther (please specify) 1=. ,n the case of minors: Surname8 first name8 a!!ress (if !ifferent from applicant>s) an! nationality of Name: parental authority%le"al "uar!ian # )ther 11. National i!entity number8 <here applicable

File han!le! by: Supportin" !ocuments: # *ra'el !ocument # +eans of subsistence # ,n'itation # +eans of transport # *+, # )ther:

12. *ype of tra'el !ocument # )r!inary passport # Diplomatic passport # Ser'ice passport # )fficial passport # Special passport # )ther tra'el !ocument (please specify) 10. Number of tra'el !ocument 12. Date of issue 14. Vali! until 16. ,ssue! by

17.

pplicant's home a!!ress an! e3mail a!!ress

*elephone number(s)

19. -esi!ence in a country other than the country of current nationality # No # ?es. -esi!ence permit or e@ui'alent AAAAAAA No. AAAAAAAA.. Vali! until 1 1:. &urrent occupation B 2=. $mployer an! employer's a!!ress an! telephone number. For stu!ents8 name an! a!!ress of e!ucational establishment. 21. +ain purpose(s) of the Courney: # *ourismAA.# (usinessAA.# Visitin" family or frien!s A.# &ultural AA# Sports AA..# )fficial 'isit # +e!ical reasons # Stu!y ..# *ransit # irport transit # )ther (please specify) 22. +ember State(s) of !estination 20. +ember State of first entry

Visa !ecision: # -efuse! # ,ssue!: # #& # .*V # Vali!: From /ntil Number of entries: # 1 # 2 # +ultiple Number of !ays:

x 1

Fields 1-3 shall be filled in in accordance with the data in the travel document

The fields marked with * shall not be filled in by family members of EU, EEA or ! citi"ens #s$ouse, child or de$endent ascendant% while e&ercisin' their ri'ht to free movement( Family members of EU, EEA or ! citi"ens shall $resent documents to $rove this relationshi$ and fill in fields no 3) and 3*(

22. Number of entries re@ueste! # Sin"le entryA.# *<o entries A.# +ultiple entries

24. Duration of the inten!e! stay or transit ,n!icate number of !ays

26. Schen"en 'isas issue! !urin" the past three years # No # ?es. Date(s) of 'ali!ity from AAAAAAA . to 27.Fin"erprints collecte! pre'iously for the purpose of applyin" for a Schen"en 'isa # No AAAAAAAAAAAA# ?es. AAAAAAAAAAAAAA. Date8 if Dno<n 29. $ntry permit for the final country of !estination8 <here applicable ,ssue! by AAAAAAAAAAAA..Vali! from AAAAAAAAAAuntil AAAAAAAAAAAAAAAAAA. 2:. ,nten!e! !ate of arri'al in the Schen"en area 0=. ,nten!e! !ate of !eparture from the Schen"en area B 01. Surname an! first name of the in'itin" person(s) in the +ember State(s). ,f not applicable8 name of hotel(s) or temporary accommo!ation(s) in the +ember State(s) !!ress an! e3mail a!!ress of in'itin" person(s)%hotel(s)%temporary accommo!ation(s) *elephone an! telefax

B02. Name an! a!!ress of in'itin" company%or"anisation

*elephone an! telefax of company%or"anisation

Surname8 first name8 a!!ress8 telephone8 telefax8 an! e3mail a!!ress of contact person in company%or"anisation

B00. &ost of tra'ellin" an! li'in" !urin" the applicant's stay is co'ere! # by the applicant himself%herself # by a sponsor (host8 company8 or"anisation)8 please specify AA.# referre! to in fiel! 01 or 02 AA.# other (please specify) +eans of support # &ash # ccommo!ation pro'i!e! # ll expenses co'ere! !urin" the stay # 5re3pai! transport # )ther (please specify)

+eans of support # &ash # *ra'eller's che@ues # &re!it car! # 5re3pai! accommo!ation # 5re3pai! transport # )ther (please specify)

02. 5ersonal !ata of the family member <ho is an $/8 $$ Surname Date of birth

or &E citiFen First name(s) Number of tra'el !ocument or ,D car!

Nationality

04. Family relationship <ith an $/8 $$ or &E citiFen # spouse AAAAA..# chil! AA# "ran!chil! AAAAAA# !epen!ent ascen!ant 06. 5lace an! !ate 07. Si"nature (for minors8 si"nature of parental authority%le"al "uar!ian)

, am a<are that the 'isa fee is not refun!e! if the 'isa is refuse!. pplicable in case a multiple3entry 'isa is applie! for (cf. fiel! No 22): , am a<are of the nee! to ha'e an a!e@uate tra'el me!ical insurance for my first stay an! any subse@uent 'isits to the territory of +ember States.

, am a<are of an! consent to the follo<in": the collection of the !ata re@uire! by this application form an! the taDin" of my photo"raph an!8 if applicable8 the taDin" of fin"erprints8 are man!atory for the examination of the 'isa applicationG an! any personal !ata concernin" me <hich appear on the 'isa application form8 as <ell as my fin"erprints an! my photo"raph <ill be supplie! to the rele'ant authorities of the +ember States an! processe! by those authorities8 for the purposes of a !ecision on my 'isa application. Such !ata as <ell as !ata concernin" the !ecision taDen on my application or a !ecision <hether to annul8 re'oDe or exten! a 'isa issue! <ill be entere! into8 an! store! in the Visa ,nformation System (V,S) 2 for a maximum perio! of fi'e years8 !urin" <hich it <ill be accessible to the 'isa authorities an! the authorities competent for carryin" out checDs on 'isas at external bor!ers an! <ithin the +ember States8 immi"ration an! asylum authorities in the +ember States for the purposes of 'erifyin" <hether the con!itions for the le"al entry into8 stay an! resi!ence on the territory of the +ember States are fulfille!8 of i!entifyin" persons <ho !o not or <ho no lon"er fulfil these con!itions8 of examinin" an asylum application an! of !eterminin" responsibility for such examination. /n!er certain con!itions the !ata <ill be also a'ailable to !esi"nate! authorities of the +ember States an! to $uropol for the purpose of the pre'ention8 !etection an! in'esti"ation of terrorist offences an! of other serious criminal offences. *he authority of 1reece responsible for processin" the !ata is: +inistry of &itiFen 5rotection8 1reeD 5olice8 ,nternational 5olice &ooperation Di'ision8 0r! Di'ision S,-$N$8 Hanellopoulou 28 1-I 1=1 77 thens8 *el.:J0=.21=.6:77===8 Fax:J0=.21=.6:2:7628 $mail: infoKsirene3"r.com , am a<are that , ha'e the ri"ht to obtain in any of the +ember States notification of the !ata relatin" to me recor!e! in the V,S an! of the +ember State <hich transmitte! the !ata8 an! to re@uest that !ata relatin" to me <hich are inaccurate be correcte! an! that !ata relatin" to me processe! unla<fully be !elete!. t my express re@uest8 the authority examinin" my application <ill inform me of the manner in <hich , may exercise my ri"ht to checD the personal !ata concernin" me an! ha'e them correcte! or !elete!8 inclu!in" the relate! reme!ies accor!in" to the national la< of the State concerne!. *he national super'isory authority of that +ember State LEellenic Data 5rotection uthority8 Hifisias str 1308 1st floor8 1- I 114 20 thens8 *el.: J0=.21=.62746==8 Fax:J0=.21=.62746298 $3 mail: contactK!pa."rM <ill hear claims concernin" the protection of personal !ata. , !eclare that to the best of my Dno<le!"e all particulars supplie! by me are correct an! complete. , am a<are that any false statements <ill lea! to my application bein" reCecte! or to the annulment of a 'isa alrea!y "rante! an! may also ren!er me liable to prosecution un!er the la< of the +ember State <hich !eals <ith the application. , un!ertaDe to lea'e the territory of the +ember States before the expiry of the 'isa8 if "rante!. , ha'e been informe! that possession of a 'isa is only one of the prere@uisites for entry into the $uropean territory of the +ember States. *he mere fact that a 'isa has been "rante! to me !oes not mean that , <ill be entitle! to compensation if , fail to comply <ith the rele'ant pro'isions of rticle 4(1) of -e"ulation ($&) No 462%2==6 (Schen"en (or!ers &o!e) an! , am therefore refuse! entry. *he prere@uisites for entry <ill be checDe! a"ain on entry into the $uropean territory of the +ember States.

5lace an! !ate

Si"nature (for minors8 si"nature of parental authority%le"al "uar!ian):

+n so far as the ,+- is o$erational(