Please complete this form and fax to: 011-7-095-786-8155
Attention: Travel Office
Main Contact
Name: ______________________________________________________________ No. in Party: _______
Permanent Address: ____________________________________________________________________
E-mail: _______________________________ Tel: ____________________ Fax: ____________________
Group Information
Name: _________________________________________ Passport No. __________________________
Passport Expiration: ________________ Citizenship: _________________ Date of Birth: ______________
Date/Place Passport was Issued: __________________________________________________________
Name: _________________________________________ Passport No. __________________________
Passport Expiration: ________________ Citizenship: _________________ Date of Birth: ______________
Date/Place Passport was Issued: __________________________________________________________
Name: _________________________________________ Passport No. __________________________
Passport Expiration: ________________ Citizenship: _________________ Date of Birth: ______________
Date/Place Passport was Issued: __________________________________________________________
Name: _________________________________________ Passport No. __________________________
Passport Expiration: ________________ Citizenship: _________________ Date of Birth: ______________
Date/Place Passport was Issued: __________________________________________________________
Add more on separate sheet if necessary. You must also fax copies of the vital information of each passport.
Invitation Information
Type of visa requested: Single Entry, Double Entry, or Multiple Entry
Arrival Date: _________________ Departure Date: ______________________
Cities you intend to visit: ___________________________________________
City & Country where your visa will be issued: ___________________________
Fax number of embassy that will issue visa: ____________________________
Will this embassy accept a faxed invitation? ____________________________
Will this embassy accept a telexed invitation? ___________________________
Usually telex is the best way to send invitations. You will be provided with a reference number to give to the embassy, not an actual invitation.
Person Paying for Invitations
Name: _________________________________________
E-mail: ______________________________________ Tel: _________________ Fax: ________________
Date of Payment: ____________________
Please see Natasha Stetsik in our travel office to pay for the invitations. Prices vary depending on situation. Remember that rush invitations cost extra.
Comments: ___________________________________________________________________________
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If your request is not confirmed by e-mail within 72 hours, please send this form again.