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SECTION 3 YOUR FAMILY 3.1 If you are married or living with your partner, what is your spouse/partners name? 3.2 What is your spouse / partners date of birth? 3.3 Where is your spouse / partner now?
3.4 Is your spouse / partner traveling with you? Yes 3.5 Do you have any children? Yes If you have answered yes to question 3.5, please give their details below Full name Date and place of birth Please indicate whether they are traveling with you Yes, on my passport Yes, on their passport No No No
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Please give your: 4.1 Passport number (this passport)
4.4 Is this your first passport? If you have answered no to question 4.4 please answer questions 4.5-4.7. Otherwise, please go to question 4.8 4.5 Previous passport number 4.6 Previous passport issue and expiry dates 4.7 Place previous passport was issued
4.8 4.9
Have you traveled outside your home country? Have you previously visited the BVI?
Yes Yes
No No
4.10 Have you ever been refused a visa for the BVI, or been refused entry to the BVI or had leave to enter or remain cancelled? Yes No 4.11 Have you ever been deported, removed, or otherwise required to leave the BVI? 4.12 Have you ever been refused a visa for another country? Yes Yes No No
If you have answered yes to question 4.10, 4.11, or 4.12, please complete questions 4.13 4.15 as applicable. Otherwise, please go to question 4.16 4.13 Where was your previous application made? 4.14 When was it made?
4.15 What happened? Please give the details of any forms that were served on you.
4.16 Have you ever been refused entry to, deported from, or otherwise required to leave, another country? If yes, please give details below
Yes
No
Yes
No
If you have answered yes to question 4.17 please answer questions 4.18 4.20. Otherwise please go to Section 4.21 4.18 What was your conviction for? 4.19 When and where were you convicted? 4.20 What was your sentence? (imprisonment or other penalty)
4.21 Have you ever been concerned in the commission, preparation, organization or support of acts of terrorism or have you ever been a member of an organization which has been involved in or advocated terrorism in furtherance of its aims? Yes No 4.22 Have you ever been concerned in the commission, preparation or organization of genocide or crimes, including crimes against humanity and war crimes, committed in the course of armed conflict? Yes No
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If you have answered yes to questions 4.21 or 4.22, please give details below
SECTION 5 ABOUT YOUR STAY IN THE BVI 5.1 How long do you intend to stay in the BVI? 5.2 On what date do you intend to arrive? 5.3 Why are you going there? _________________________________________________ _________________________________________________ _________________________________________________
5.4 Please give the full address and telephone number of all the places where you will be staying during your visit, and the name and relationship of the person (s) you will be staying with Name Relationship (if any) Address Contact telephone number
SECTION 6 YOUR FINANCES AND EMPLOYMENT DETAILS 6.1 What is your present job? 6.3 What is your work address? 6.4 Your employers telephone number 6.5 Your employers fax number 6.6 Your employers e-mail address 6.2 When did you start this job?
6.7 What is your monthly income from employment? 6.8 Do you receive income from any other sources, including friends or family: 6.9 Do you own any assets, for example property? If you have answered yes to questions 6.8-6.9 please give details below
6.10 How much money is available to you for your trip? 6.11 Who is paying for your trip? SECTION 7- OTHER INFORMATION Is there any other information you wish to give about your application?
__________________________________________________ __________________________________________________
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SECTION 8 DECLARATION To be completed by all applicants Data Protection Statement
The British Virgin Islands, Visa Section is processing the personal data on this form and related data for the purposes of promoting and protecting the interests of the British Virgin Islands. The data may be disclosed to other BVI Government Departments and public authorities. Declaration You must now read the declaration below and sign it. This must be signed by the applicant personally and not by a representative or other person acting on his/her behalf. An application for a person under the age of 18 may be completed by the parent or legal guardian. I hereby apply for an entry clearance for the British Virgin Islands for myself and any dependants listed in this form. The information I have given is complete and is true to the best of my knowledge. I also declare that the photograph(s) submitted with this form is / are a true likeness of myself and any dependants included in the application. I confirm that if, before this application is decided, there is a material change in my circumstances or new information relevant to this application becomes available, I will inform the British Virgin Islands diplomatic post at which I have applied. I am aware that it is an offence under the Immigration & Passport Ordinance, Cap 130, to make to a person acting in execution of the Act a statement or representation which the maker knows to be false or does not believe to be true, and to obtain or seek to obtain leave to enter in the British Virgin Islands by means which include deception. I declare that the information given on this form is correct to the best of my knowledge and belief. Applicants signature: ________________________________________________________ FOR OFFICE USE ONLY Date: ________________
Check 1 by Cash register details ISSUE (tick) Authorised by (VO) Category Endorsement Pol. Reg. Visa number Checked by (VM)
Code
Y/N
Effective from
Expiry date
Name
Date