cameroon - American Visa of DC

AMERICAN VISA OF DC
1801 Columbia Rd., NW #200, Washington, DC 20009
Tel: 202-462-5908 Fax: 202-387-5430
Email: [email protected] www.americanvisadc.com
_____________________________________________________________________________________________________
THIS IS NOT AN APPLICATION; IT IS ONLY A COVERING LETTER FOR AMERICAN VISA OF DC
CAMEROON
Visa Requirements:
•
Signed Passport valid for six months with at least one blank visa page.
•
Two visa application forms completed, printed and signed.
•
One copy of the of the health certificate showing vaccination for Yellow Fever.
•
Two color passport sized photos 2" x 2" ONLY on white or very light background.
An invitation letter from the company in Cameroon, with a company seal (for business visa).
•
•
A letter of financial responsibility from the company in the U.S.A. (For business visa).
•
Copy of flight itinerary from the travel agent or a copy of tickets (For tourist visa).
•
Copy of hotel confirmation (For tourist visa).
Copy of recent bank statement (For tourist visit).
•
•
Copy of the Green Card (For Non-U.S. Citizens).
Validity of Visas: Single entry visas are valid for three months and multiple entry visas are valid for six months.
Residents of all states can be processed in Washington DC.
Jurisdiction:
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Contact Person’s Name: ______________________________ Phone and email: ___________________________________________
SHIPPING INSTRUCTIONS: Return completed process to:
Company Name (If applicable): ____________________________________ Contact Name ___________________________
Address______________________________________________________________ Apt#/Mail Code_____________________
City____________________________________ State __________________ Zip Code _______________________________
Phone #______________________________________ Email Address _____________________________________________
TRAVELER(S) INFORMATION:
Departure Date from U.S.A.: ___________ Need by this date: ___________ *Rush fees will be applied to meet this date if necessary
1) Last Name: _______________________________________
First Name _______________________________________
Passport #:_________________________ Passport Expires: ______________________ Date of Birth_____ /_____ / ________
2) Last Name: ________________________________________
First Name ________________________________________
Passport #:_________________________ Passport Expires: ______________________ Date of Birth____ /_____ / _________
Processing Fees: (please check one)
American Visa of
DC Fee:
Cameroon
Embassy Fee
Money
Order Fee
Fed Ex
Shipping Fee
TOTAL
10 Business Days (1 to 3 month):
$75
$93
$25
$30
$223
7 Business Days (1 - 3 month):
$125
$93
$25
$30
$273
10 Business Days (6 month):
$75
$184
$25
$30
$314
7 Business Days (6 month):
$125
$184
$25
$30
$364
Processing Time:
•
•
Please add $15 for all applications submitted that are for Non-U.S. citizens
The processing times listed are aproximate times only. Rush processing is not guaranteed, but we do charge extra to make
extra trips and inquiries to obtain the rush process.
PAYMENT: (check one)
I authorize American Visa of DC to charge my credit card for payment of passport/visa services.
Card holders’ name _______________________________ Number __________________________ Exp. Date: ________________
Signature ________________________________________________________________________Today’s Date: ________________
Check or Money Order made out to “American Visa of DC” for $______________ enclosed.
My company has a prearranged billing agreement.
American Visa of DC Inc. assumes no responsibility for the loss, damage or delay of passports or visas caused by an Embassy, Consulate, government office,
postal or courier service, delivery service or travel agency. Requirements and fees relating to this request are subject to change without notice.
EMBASSY OF THE REPUBLIC
OF CAMEROON
AMBASSADE DE LA REPUBLIQUE
DU CAMEROUN
Tél. : (202) 265-8790
Fax : (202) 387-3826
Email: [email protected]
3400 International Drive, N.W.
Washington, DC 20008
www.cameroonembassyusa.org
VISA APPLICATION / DEMANDE DE VISA
(WRITE IN CAPITAL LETTERS ONLY / ECRIRE EN LETTRES MAJUSCULES SEULEMENT)
TRAVELER’S IDENTITY / IDENTITE DU VOYAGEUR
Surname:
Nom de Famille
Maiden Name(*):
Nom de Jeune Fille
Given Name(s):
Prénom(s)
Date of Birth:
Date de Naissance
Place of Birth:
Lieu de Naissance
City:
Ville
Country:
Pays
Nationality:
Nationalité
Origin:
Origine
Current:
Actuelle
/
Photograph
/
(Staple or glue the photo)
Day/Jour Month/Mois Year/Année
2 inches X 2 inches
Photographie
(Agrafer ou coller la photo)
Date of Naturalization(*):
/
/
Date de Naturalisation Day/Jour Month/Mois Year/Année
(*) If Applicable
Si cela s’applique
1
Parents’ Names :
Noms des Parents
Father:
Père
Marital Status:
Situation Matrimoniale
Mother:
Mère
Single/Célibataire
Married(a)/Marrié(e)
Divorced/Divorcé(e)
Unmarried but Living with a Partner(a)/Pas Marié(e) mais Vivant en Couple
Widow(er)/Veuf(ve)
(a)
Spouse’s or partner’s name, sex and phone number:
Nom, sexe et numéro de téléphone de l’époux(se) ou du(de la) partenaire
Children:
Enfants
Number:
Nombre
Age Range:
Tranche d’Age
0–5
5 – 10
10 – 15
Over 15 / Plus de 15
2
TRAVELER’S PASSPORT / PASSEPORT DU VOYAGEUR
Passport N°:
Passeport N°
Date of Issue:
Date de Délivrance
Issuing Country or Authority:
Pays ou Autorité Emettrice
Place of Issue:
Lieu de Délivrance
Date of Expiration:
Date d’Expiration
3
Profession:
Profession
Employer:
Employeur
Military Status:
Situation Militaire
4
Traveler’s Home Address
In the United States:
Adresse du Domicile du
Voyageur aux Etats-Unis :
Contact Information:
Contact
Emergency Contact:
Contact en Cas d’Urgence
Street Address
Rue
City:
Ville
Cell #: (
)
# de Cell.
Name
Nom
Apt. Nº:
Nº d’Apt
State:
Etat
Other #:(
Autre #
)
Zip Code
Code Zip
E-mail:
Phone #. (
)
Numéro de Tél.
Country:
Pays
Relationship
Lien / Relation
5
TYPE AND DURATION OF VISA REQUESTED / NATURE ET DUREE DU VISA SOLLICITE
Stay of:
Séjour de
Days
Jours
1 Month
1 mois
Entries / Entrées:
Single/Unique
Multiple/Multiple
Reason(s) for Traveling:
Motif(s) du Voyage
Tourism/Tourisme
Official/Officiel
Business/Affaires
Transit/Transit
3 Months
3 Mois
6 Months
6 Mois
Other:
Autre
Studies/Etudes
Autre/Other:
Family/Famille
Visit/Visit
6
RESERVED TO THE CONSULAR SERVICE / RESERVE AU SERVICE CONSULAIRE
DATE
VISA N°
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TRAVEL PLANS / PLANS DE VOYAGE
Date of departure from USA:
Date de départ des Etats-Unis
Place of departure from USA:
Place of departure from USA
Date of entry in Cameroon:
Date d’entrée au Cameroun
Place of entry in Cameroon:
Lieu d’entrée au Cameroun
Date of departure from Cameroon:
Date de départ du Cameroun
Place of departure from Cameroon:
Lieu de départ du Cameroun
Where do you intend to go when leaving Cameroon?:
Où comptez-vous vous rendre en sortant du Cameroun?
Specify your exact addresses during your stay in Cameroon:
Indiquez vos adresses exactes au Cameroun pendant votre séjour
7
Have you ever visited Cameroon? If yes, When?
Avez-vous déjà visité le Cameroun? Si oui, A quelle(s) date(s)?
Have you ever made an uninterrupted stay of more than three (03) months in Cameroon?
Avez-vous déjà habité le Cameroun pendant plus de trois (03) mois sans interruption ?
(b)
Specify the dates:
Précisez à quelles dates
YES/OUI(b)
NO/NON
Relatives in Cameroon (exact addresses):
Attaches familiales au Cameroun (adresses exactes)
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References in Cameroon (name and exact address)
Références au Cameroun (nom et adresse exacte):
Give names and addresses of businessmen/manufacturers you wish to meet if this is a business trip
Indiquez les noms et adresses des commerçants/industriels que vous désirez rencontrer s’il s’agit d’un voyage d’affaires:
Do you intend to establish a business in Cameroon?
Comptez-vous installer au Cameroun un commerce ou une industrie ?
(c)
Please specify/explain :
Veuillez Spécifier/Expliquer
YES/OUI(c)
NO/NON
9
Do you agree not to accept any employment, either at a salary or for room and board during your stay in Cameroon, not to seek to remain in Cameroon
permanently and to leave the Cameroonian territory at the expiration of the visa that may be granted to you?
Vous engagez-vous à n’accepter aucun emploi rémunéré ou au pair durant votre séjour au Cameroun, à ne pas chercher à vous y installer définitivement et
à quitter le territoire à l’expiration du visa qui vous sera éventuellement accordé?
YES/OUI
NO/NON
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Note regarding relatives/references, their contact information (address/phone number) and the traveler’s address during the stay in Cameroon
Remarque concernant les attaches familiales/références, leurs coordonnées (adresse/téléphone) et l’adresse du voyageur pendant le séjour au Cameroun
When indicating relatives or references in Cameroon, specify the relationship to said relatives or references and a contact phone number.
When indicating exact addresses, be as precise as possible, indicating the city/village, the quarter, any landmark near the place of residence, the name and
contact information (phone number) of the hosting party; if necessary, the additional information can be typed on a separate sheet of letter-size paper.
En indiquant les attaches familiales ou les références au Cameroun, spécifier le lien de parenté/la relation et inclure un numéro de téléphone.
En indiquant les adresses exactes, être aussi précis(e) que possible, indiquer la ville/le village, le quartier, tout point de repère reconnu à proximité du lieu de
résidence, le nom et les coordonnées (numéro de téléphone) de l’hôte; si nécessaire, les informations supplémentaires peuvent être saisies sur une feuille de
papier additionnelle de format lettre.
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My signature renders me responsible and exposes me, in case of any false statements, and in addition to any penalties imposed by
law, to be denied any Cameroonian visa in the future.
Ma signature engage ma responsabilité et m’expose, en sus de poursuites prévues par la loi en cas de fausse déclaration, à me voir
refuser tout visa camerounais à l’avenir.
Signature (Must be that of the applicant, or of the legal guardian in case of under-aged applicant)
(Doit être celle du demandeur, ou bien du tuteur légal si le demandeur est mineur)
Date
12
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