GHANA (Multiple Entry), TOGO and BENIN

TOURIST VISA REQUIREMENTS
GHANA (Multiple Entry), TOGO and BENIN
Total cost
5
One person
Total cost
Two people
$538
$1058
Cost includes, consular fees* and return shipping
For delivery outside the contiguous U.S. please add additional $35.00. 
For FedEx Overnight Delivery please add $10.00 to above costs. 
Please Send to GENERATIONS VISA SERVICE: (see address below)
__ Your signed passport: having four completely blank “visa” pages & six months validity beyond the travel
date. For help with passport processing, including adding visa pages, call GenVisa at 1-800-845-8968.
__ Six (6) recent passport photos per person (approx 2x2) – no home photos / no photocopies.
__ Two completed and signed visa application forms per person for Togo and Ghana and one for Benin (attached).
__ Three (3) copies of International Certificate of Vaccination for Yellow Fever is required.
__ Three (3) copies of your flight itinerary provided by Road Scholar Travel Services. If you are traveling as a
program only participant and making your own flight arrangements, please submit an international travel I
itinerary on airline, website or travel agency letterhead.
__ Payment: a check or money order payable to GenVisa in US Dollars and drawn on a US bank.
Complete and return this entire form with the requested materials – use a traceable form of mail.
Important: Do not send your passport/materials more than 3 months prior to your program departure date.
If you need your passport returned within 45 days: add $125 per person for expedited service. If you are
departing within 30 days: add $305 per person for expedited service, within 14 days: call GenVisa prior to
sending your materials.*Consular fees and forms are subject to change without notice. For terms and
conditions, current requirements, updated forms and fees please go to www.genvisa.com/roadscholar
YOUR RETURN ADDRESS
Last Name: _______________________________________________ First Name: ________________________________________
Last Name: _______________________________________________ First Name: ________________________________________
Return to:  Home or  Business (recommended for security reasons) Name & c/o:_____________________________________
EXACT address: _______________________________________________ Apt/Ste#: _______ Phone: ________________________
City: __________________________________ State: _____________ Zip Code: ____________________
Date you need your passport: _______________Your E-mail address (Important): ________________________________
Date THIS PROGRAM Departs US: ____________________ Program/Booking # (Important) _______________
Optional insurance: $8.00 per passport: in the unlikely event that your passport is lost or damaged in transit. This will cover
your full out of pocket visa(s) and passport replacement costs up to $2,000. Please check one of the boxes below.
 Yes, I have added an additional $8.00 per person for the optional insurance. [FedEx signature required upon delivery.]
 No, I decline the optional insurance and understand that in the unlikely event my passport is lost or damaged,
Generations Visa Service liability is limited to $100. [No signature required upon delivery.]
Send materials to:
GENERATIONS VISA SERVICE
2233 WISCONSIN AVE N.W. #226
WASHINGTON D.C. 20007-4119
1-800-845-8968
Road Scholar – Ghana/Togo/Benin
Please check applicable box
For Official Use
Visa No.: _______________________________
Type of Visa: ____________________________
Date of Issue: ____________________________
Charges: _______________________________
Issuing Officer: ___________________________
✔
Single Entry $60.00
Multiple Entries $100.00
Single Entry (Rush) - $100.00
Multiple Entries (Rush) $200.00
Affix passport
Picture here
(Pay by money order.
Personal checks are not accepted)
Application for Ghana Entry Permit/Visa
Embassy of Ghana, 3512 International Drive NW - Washington DC 20008
Website: www.ghanaembassy.org Tel: (202) 686-4520
______________________________________________________________________________________________________
INSTRUCTIONS:
1. This form must be completed in duplicate and in capital letters and submitted (together with two(2) recent passportsize pictures) at least Fourteen (14) days before the intended date of departure.
2. Full names and addresses of references/hotel (place of stay) in Ghana should be stated (including telephone numbers, if
available).
3. Any information stated on the form and subsequently found to be incorrect may render entry permit/visa void.
4. Applicants applying by post/mail should provide trackable return self-addressed envelopes.
______________________________________________________________________________________________________
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
(a) Surname:___________________________________ First Name (s): ___________________________________
Previous Name (if applicable) ______________________________________________________________________
(b)Date of Birth: _________________________________ (c) Place of Birth: _________________________________
(d) Nationality: __________________________________ (e) Former Nationality (if any) ________________________
(f) Passport No.:_________________________________ (g) Date of Issue: _________________________________
(h) Place of Issue: ________________________________ (i) Date of Expiry: ________________________________
Profession/Occupation: ___________________________________________________________________________
(a) Business Address & Tel. No. in the U.S.A:
______________________________________________________________________________________________
(b) Residential Address & Tel. No. in the U.S.A:
______________________________________________________________________________________________
Proposed date of departure for Ghana: _______________________________________________________________
(a) Traveling by: □ Air □ Sea □ Land
(b) Is applicant in possession of return ticket? ____________________________ Ticket No.:_____________________
(c) Amount of Money Applicant is traveling with_________________________________________________________
Purpose of Journey: □ Business □✔ Tourism
□ Employment □ Official
□ Student □ Transit
Names, Addresses and Telephone Numbers of Two (2) references or place of residence in Ghana/Name(s) of Hotel: (very
important)
(i) ____________________________________________________________________________________________
______________________________________________________________________________________________
(ii) ____________________________________________________________________________________________
______________________________________________________________________________________________
If for employment, name and address of employer in Ghana ______________________________________________
______________________________________________________________________________________________
Duration of stay in Ghana: _________________________________________________________________________
Date of last visit to Ghana: _________________________________________________________________________
Applicant’s signature: _____________________________________ Date of application: _______________________
NB: PLEASE ENSURE YOU ENCLOSE YOUR PASSPORT WITH YOUR APPLICATION
EMBASSY OF THE REPUBLIC OF TOGO
2208 Massachusetts Avenue, NW,
Washington DC 2008
Phone: 202-234-4212
Fax: 202-232-3190
LIBERTE
attach photo
For Official Use:
Visa #:
Type of Visa:
Date of Issue:
Charges:
Signature of Issuing officer:
RT
APPLICATION FOR REPUBLIC OF TOGO ENTRY PERMIT / VISA
1.(a) Applicant Surname:
Applicant First names:
Previous names (if applicable):
b. Date of Birth:
c. Place of Birth:
d. Nationality / Current Citizenship:
e. Former Nationality (if any)
f. Other citizenships held/ previous citizenships:
g. Passport date of issue:
h. Passport Place of issue: US Dept of State
i. Passport Number:
j. Passport date of expiration:
2. Current Profession or Occupation:
3(a). Business address / phone / fax / e mail:
3(b). Residential address / phone / fax / e mail:
4. Proposed date of Departure:
5. Traveling by:
Is applicant in possession of a return ticket?
Ticket issuer & number:
6. Purpose of journey:
Business
X Tourism
Air
Employment
7. Names and addresses of two references:
(i)
(ii)
8. If for employment, name and address of employer:
9. Duration of stay:
10. Date of last visit:
11. Applicant signature:_____________________________
Date:
Sea
Land
Official
REPUBLIQUE DU BENIN
------------AMBASSADE DU BENIN AUX ETATS-UNIS D’AMERIQUE
EMBASSY OF THE REPUBLIC OF BENIN
2124 Kalorama Road N.W.
Washington, D.C. 20008
RESERVE AU CONSULAT
REFERENCE :
TAXES PERCUES :
MODE DE PAIEMENT :
------------
DEMANDE DE VISA
APPLICATION FOR VISA
-:-:-:-:-:-:-:-:-:Nom (en capitales)________________________________________________
Surname (in capitals)
Née :___________________________________________________________
(Nom de jeune fille – Maden Name)
Prénoms :_______________________________________________________
First names (in small letters)
PHOTOGRAPH
Né le_______________________________à___________________________
Born on
at
D’origine :______________________________
Nationalité
at birth
Nationality
actuelle :________________________________
present
Situation de famille :_______Enfants : Nombre_____Ages__________ ______
Married or single
Number of children
Ages
Passport N°___________________________________
Résidence (adresses exacte)___________________________ ______________
Present address in full
Délivrée le ____________________________________
issued on
Téléphone_______________________________________________________
Phone
Par :________________________________________ _
By
Profession:________________________________________ ____________ _
Occupation
Valable jusqu’au_______________________ _______
Valid until
Situation militaire :________________________________________________
Military service status
Transit à destination de :________________
Transit en route to
Avec arrêt de : ________________________jours
With a stay of
Nature et durée du visa sollicité :
(Le cadre ci-contre doit être rempli par le:
demandeur qui rayera les mentions inutiles)
Type and validity of visa requested :
(The space opposite should be filled in)
SEJOUR DE :_______________jours
STAY OF
days
________________mois
months
( ) unique
( ) multiple
Motifs du voyage :______________________________________________________________________________________________________
Reason for journey
______________________________________________________________________________________________________________________
Avez-vous déjà résidé en République du Bénin pendant plus de trois mois sans interruption ?____________________________________________
Have you already resided in the Republic of Benin for more than three months continuously?
Précisez à quelle date:_____________________________________________________________________________________________________
When (give exact date) :
Attaches familiales en République du Bénin (adresses exactes ) rue et n°______________________________________________________________
Have you any relations in the Republic of Benin (give full addresses, including street and street number
______________________________________________________________________________________________________________________
2
Références dans le pays de résidence (adresse) :______________________________________________________________________________
Reference in the country of residence (give full address)
_______________________________________________________________________________________________________________________
Indication précise du lieu d’entrée en République du Bénin :___________________________________________________________________
State exact point of entry into the Republic of Benin
_______________________________________________________________________________________________________________________
Indication de vos addresses exactes en République du Bénin pendant que vous y séjournerez________________________________________
State your full address, during your stay in the Republic of Benin
______________________________________________________________________________________________________________________
Comptez-vous installer en République du Bénin un Commerce ou une Industrie ?_________________________________________________
Do you intend to establish a business or a factory in the Republic of Benin?
Où comptez-vous vous rendre en sortant de la République du Bénin ?__________________________________________________________
Where do you intend to go upon your departure from the Republic of Benin?
Je déclare avoir donné des réponses exactes et complètes à toutes les questions de la présente demande.
I declare that I have answered all required questions in this application fully and truthfully.
_____________________________ _____
Signature du requérant
Signature of Applicant
_________________________________
Date
Smart Traveler Enrollment Program
“Stay Informed, Stay Connected, Stay Safe!”
For a nominal fee GenVisa will register you and your travel details with the nearest U.S.
Embassy or Consulate in the countries you are visiting.
This key feature allows the US government to efficiently safeguard its citizens while overseas.
Benefits of Enrolling in Smart Traveler Enrollment Program



Receive important information from the Embassy about up-to-the-minute safety conditions in your
destination country, helping you make informed decisions about your travel plans.
Help the U.S. Embassy contact you in an emergency, whether natural disaster, civil unrest, or family
emergency.
Help family and friends get in touch with you in the case of an emergency.
Personal Information
Traveler #1:
Full name (LAST, First, Middle):
Traveler #2:
Full name (LAST, First, Middle):
Date of Birth (MM/DD/YYYY):
/
/
Passport Number:
Date of Issue (MM/DD/YYYY):
/
/
Expiration Date (MM/DD/YYYY):
/
/
Home Address:
Date of Birth (MM/DD/YYYY):
/
/
Passport Number:
Date of Issue (MM/DD/YYYY):
/
/
Expiration Date (MM/DD/YYYY):
/
/
Home Address:
Email Address*:
Phone Number:
Email Address*:
Phone Number:
*Email addresses will not be used for solicitation purposes
Travel Information
Country #1:
Approx. Date of Entry (MM/DD/YYYY): / /
Approx. Date of Exit (MM/DD/YYYY): / /
Name and Address of the first hotel:
Country 2 (if applicable):
Approx. Date of Entry (MM/DD/YYYY): / /
Approx. Date of Exit (MM/DD/YYYY): / /
Name and Address of the first hotel:
Contact in Country (phone or email):
Contact in Country (phone or email):
 Yes, please enroll me in Smart Traveler Program. I have added an additional $12.50 per person for this service.
 No, I decline the optional Smart Traveler Program enrollment service.
Please note: An email confirmation will be sent to your email on record and you
must confirm using the link in the email within 48 hours.