Visa Application Form

Photo
1. First Name (s) :
Cadre rserv aux
services

de l'Amassade
ou
du Consulat

!. Famil" Name (s) :

#ate
d'introduction de
la demande :
$. #ate o% &irth '. (dentit" Card Numer :
(For minors write mention "minors")

)esponsale du
dossier :
*. Place and Countr" o% irth :

+. Current Nationalit" ,. -ri.inal Nationalit" (Nationalit" o% irth)
Visa :
Refus
/. 0ex: 1. 2arital situation : Accord
Male Female Single Married Separated Annul
Divorced Widow
t!er "
3"pe et cat.orie
du visa :

14. Father's name and Famil" Name 11. 2other's Name and Famil" Name


Nomre
d'entres :
1!. 3"pe o% Passport Ordinary Passport Diplomatical Passport # $
Service %assport or e&uivalent 'ravel document for refugier or apatried Multiples
t!er
Valale du
1$. Passport Numer : 1'. (ssued "
0erial Numer : Au

1*. #ate o% issue : 1+. Valid until :

2oti% : (5n cas
de )e%us
ou d'Annulation)
1,. Pro%ession :

1/. Purpose o% 3ravel :
'ourism Affairs Famil( visit

)ulture*Sport
fficial visit Medical %urpose Studies ot!er (%recise)

11. 3"pe o% visa !4. Numer o% entries !1. #uration o% sta":
+ong validit( Single entr( ,um-er of da(s"
S!ort validit( 'wo entries
'ransit Multiples entries

!!. Arrival date !$. &order o% entr" !'. 2ean o% transport:
or transit route:

!*. Previous visas :
Date Number
Place of issue
Duration
1
2
3

!+. (n case o% transit6 have "ou un entr" permit to entr" to Final Countr"
,o .es

Countr" o% destination :

Valid until :
Delivered -( "

!,. 7ost or 7ost compan" :
(if not/ indicate name of a temporar( address in Morocco)
,ame "
Address "

'elep!one ,um-er " Fa0 "

1mail"

!/. 8ho is pa"in. %or "our travel and "our needs durin. "our sta"9
M( self 2ost (s) 2ost compan( (3ndicate t!e names and t!e modalities
and present corresponding documentation)

!1. Financial 2eans used durin. "our sta":
Mo(ens de financement utiliss au cours du s4our "
Mone( ()as!) 'raveller )!e&ues )redit )ard Accomodation

t!ers
'ravel 3nsurance and*or Medical 3nsurance 5 6alid until

$4. Children (individual application %or each passport)
Family Name First Name Date of Birth
1
2
3

I declare that all information I advanced is correct and complete. I am
conscious of the fact that any false declaration will lead to the rejection
of application or the annulment of the visa if already issued and may
lead to legal proceedings according to the regulations in force in
Morocco.
Note :
In addition to your valid passport and you should !e a!le during
your passage through the Moroccan frontier to present all documents
that may justify your return and your stay" your su!sistence means"
insurance statement" etc
#ntry to the Moroccan territory may !e refused to the alien who does
not fulfil all these re$uirements
Providing all the re$uired documents does not necessarily open
right to visa

$1. Applicant address: $!. Phone:

$$. #one in: $'. Firm: