VIP PASSPORT SERVICES, INC. - VIP Passports and Visa Services

VIP PASSPORT SERVICES, INC.
2012 Louisiana Street
Houston, Texas 77002
713-659-8472 1-800-856-8472 Fax 713-659-3767
W e b s i t e : www.vippassports.com E m a i l : i n f o @ v i p p a s s p o r t s . c o m
WORK ORDER REQUEST FORM
(RETURN THIS FORM WITH EACH REQUEST)
BILLING INFORMATION:
RETURN DOCUMENTS TO:
CONTACT: _____________________________
CONTACT: ______________________
COMPANY: _____________________________
COMPANY: ______________________
ADDRESS: _____________________________
ADDRESS: ______________________
CITY/ST: _____________________________
CITY/ST: ______________________
PHONE:
_____________________________
PHONE:
______________________
CELL:
_____________________________
CELL:
______________________
FAX:
_____________________________
FAX:
______________________
EMAIL:
_____________________________
EMAIL:
______________________
CREDIT CARD INFORMATION:
BILLING INSTRUCTIONS:
CARD#: _______________________________
YOUR P.O. OR REF#:_____________
EXP. DATE: _______
CVV#: ________
SIGNATURE OF CARD HOLDER
REQUIRED: _________________________
AUTHORIZED AMOUNT TO CHARGE MY
CREDIT CARD: US$______________
TRAVELERS NAME: ______________________
DATE OF USA DEPARTURE:
DATE OF BIRTH:
DATE YOU NEED PASSPORT: ________
______________________
________
VIP RESERVATION/FILE LOCATOR NUMBER: ___________
SPECIAL INSTRUCTIONS: ____________________________________________________
__________________________________________________________________________
HOW DID YOU HEAR ABOUT VIP?
REPEAT CUSTOMER__ INTERNET__ REFERRED___ BY_________________ WALK-IN_____
Specializing in Visas, Passports, Document Legalization and Translations
VIP SERVICES
2012 Louisiana Street
Houston, Texas 77002
713-659-8472 1-800-856-8472 Fax 713-659-3767
W e b s i t e : www.vippassports.com E m a i l : i n f o @ v i p p a s s p o r t s . c o m
VISA INSTRUCTION SHEET
APPLICATION (S) REQUESTED FOR:
BURKINO FASO TOURIST VISA
DOCUMENTS REQUIRED:
VALID PASSPORT:
PASSPORT TYPE PHOTO (S):
INT’L HEALTH CERTIFICATE:
COPY OF INVITATION:
OTHER:
1
2
1
N/A
APPLICATION (S):
ITINERARY/TICKET:
COMPANY LETTER:
RELEASE LETTER:
2
1-COPY
N/A
N/A
SEE NEXT PAGE FOR MORE DETAILED INFORMATION
PLEASE FORWARD THIS SHEET AND ALL THE ABOVE REQUIREMENTS TO THE ABOVE
LISTED ADDRESS
FEES PER PERSON:
$75.00
VIP SERVICE FEE: (REGULAR PROCESS)
CONSULATE FEE:
$6.00
MONEY ORDER:
**
□
SPECIAL HANDLING FEE: (48 TO 72 HOUR RUSH PROCESS)
OTHER FEES:
*ADD RETURN FEDERAL EXPRESS FEE:
TOTAL:
(NO PERSONAL CHECKS PLEASE)
*FEDERAL EXPRESS FEES:
**VISA PROCESSING TIME
PRIORITY LETTER
$21.00
REGULAR PROCESSING TIME:
4 TO 7 DAYS
2-DAY LETTER
$13.50
3-DAY LETTER
$11.50
SATURDAY LETTER
$31.00
PLEASE MARK THE APPROPRIATE BOX IF YOU NEED
TO HAVE VIP REQUEST THAT THE VISA BE ISSUED
WITHIN 48 TO 72 HOURS FROM THE DAY THAT WE
SUBMIT YOUR APPLICATION ($20.00 SPECIAL
HANDLING FEE).
COMMENTS:
REVISED:
06-07-2013 (KS)
Specializing in Visas, Passports, Document Legalization and Translations
VIP SERVICES
2012 Louisiana Street
Houston, Texas 77002
713-659-8472 1-800-856-8472 Fax 713-659-3767
W e b s i t e : www.vippassports.com E m a i l : i n f o @ v i p p a s s p o r t s . c o m
BURKINA FASO
PLEASE SUBMIT THE FOLLOWING REQUIREMENTS
TOURIST VISA:
1.) U.S. PASSPORT (MINIMUM OF 1-YEAR REMAINING VALIDITY
AND AT LEAST 1 BLANK VISA PAGE)
2.) (2) TWO PASSPORT-TYPE PHOTOGRAPHS (2x2)
3.) (2) TWO COMPLETED APPLICATIONS
4.) A COPY OF YOUR TRAVEL ITINERARY
5.) YOUR INTERNATIONAL HEALTH CERTIFICATE
SHOWING A CURRENT YELLOW FEVER IMMUNIZATION
6.) CONSULATE FEE:
$140.00 – MULTIPLE ENTRY (4 TO 7 DAY PROCESS)
$190.00 – MULTIPLE ENTRY (2 TO 3 DAY PROCESS)
BUSINESS VISA:
1.) U.S. PASSPORT (MINIMUM OF 1-YEAR REMAINING VALIDITY
AND AT LEAST 1 BLANK VISA PAGE)
2.) (2) TWO PASSPORT-TYPE PHOTOGRAPHS (2x2)
3.) (2) TWO COMPLETED APPLICATIONS
4.) A COMPANY LETTER OF GUARANTEE
5.) A COPY OF YOUR TRAVEL ITINERARY
6.) YOUR INTERNATIONAL HEALTH CERTIFICATE
SHOWING A CURRENT YELLOW FEVER IMMUNIZATION
7.) CONSULATE FEE:
$140.00 – MULTIPLE ENTRY (4-7 DAY PROCESS)
$190.00 – MULTIPLE ENTRY (2-3 DAY PROCESS)
VALIDITY: THE CONSULATE CAN ISSUE THE VISA VALID FROM 90 DAYS
TO A 5 YEAR MULTIPLE ENTRY. THE VALIDITY IS
DETERMINED BY THE VISA OFFICER ON AN INDIVIDUAL
CASE BY CASE BASIS.
REVISED: 06-07-2013 (KS)
Specializing in Visas, Passports, Document Legalization and Translations
AMBASSADE DU BURKINA
FASO A WASHINGTON D.C.
2340 Massachusetts Ave, D.C 20008
Washington, D.C – USA
tél: (202) 332-5577 – fax: (202) 667-1882
Photographie
DEMANDE DE VISA
DE TRANSIT OU DE SEJOUR AU BURKINA FASO
N°______/AMBF/WASH
Informations du demandeur
du……/……/……
Nom (en lettre capitale) : ……………………………………………………………….................................................
Name
Née (Nom de jeune fille) : ……………………………………………………………………………………………………
Maiden name
Prénoms : ………………………………………………………………………………………………………………………
Given names
Né(e) le : …. / …. / …….. (JJ/MM/AAAA) à …..………………………………………………….. Sexe : M
F
Sex
Date of birth (dd/mm/yyyy)
Nationalité d'origine : …………………………………………………………………………………………………………
Place of birth
Nationality of origin
Nationalité actuelle : ………………………………………………………………………………………………………….
Nationality
Situation de famille : ……………………………………………… Nombre d'enfants : ………………………..……..…..
Relationship status
Number of children
Adresse du demandeur : ………………………………………………………………………………….………………….
Address
Contact : ………………………………………………………………………………………………………………………..
Phone number
Profession : ……………………………………………………………………………………............................................
Occupation
Informations Visa
Transit
à destination de : ……………………………… date d’arrivée : ……/……/………………………
Transit
Going to
Arrival date
Séjours
durée du séjour : …………………….
Nombre d’entrées :
Stay
Length of the stay
Une……
Multiples
Number of entrance
Motif du voyage : …………………………………………Type du visa:…………………………………………………..
Purpose of travel
………………………………………………………………………………………….………………..………………………
Lieu(x) de destination : ……………………………………………………………………..…………………………………
Destination
………………………………………………………………………………………............……………..……………………
Adresse au Burkina Faso : ……………………………………………………………..…………….....……………………
Address in Burkina
Contact : ……..…………………………………………………………………………..……………….……………………
Phone number
Informations Passeport
N° du passeport : …………………..
Passport number
Date d'expiration : …. / …. / …….. (JJ/MM/AAAA)
Validity date (dd/mm/yyyy)
Délivré le : …. / …. / …….. (JJ/MM/AAAA)
par : ……………………………….……………………………………………
Issued date (dd/mm/yyyy)
Place of issue
Fait à……………………,
Le …. / …. / ……..
At
(JJ/MM/AAAA)
Signature du demandeur
Signature