Formulaire
de demande de visa
Formulaire de demande de visa
Une
copie de cette demande sera envoyée au Ministère des Affaires
étrangères. Des
formes incomplètes ne peuvent pas être traitées. Tous les champs
ci-dessous doivent être remplis.
Vos
coordonnées
Prénom:
Nom:
Sexe:
Nom
du père:
Date de
naissance (jj/mm/aaaa):
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Lieu de
naissance:
Nationalité: Veuillez
sélectionner Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua
And Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet
Island Brazil British
Indian Ocean Territory Brunei Bulgaria Burkina
Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman
Islands Central African
Republic Chad Chile China Christmas Island Cocos
(Keeling) Islands Columbia Comoros Congo Cook Islands Costa
Rica Cote D'Ivoire
(Ivory Coast) Croatia (Hrvatska) Cuba Cyprus Czech Republic D.P.R.
Korea Dem Rep of Congo
(Zaire) Denmark Djibouti Dominica Dominican
Republic East Timor Ecuador Egypt El Salvador Equatorial
Guinea Eritrea Estonia Ethiopia Falkland Islands
(Malvinas) Faroe Islands Fiji Finland France French Guiana French
Polynesia French
Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard
and McDonald Islands Honduras Hong
Kong SAR, PRC Hungary Iceland India Indonesia Iran Iraq Ireland Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea Kuwait Kyrgyzstan Lao Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands
Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk
Island Northern Mariana
Islands Norway Oman Pakistan Palau Panama Papua
new Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto
Rico Qatar Reunion Romania Russia Rwanda Saint
Kitts And Nevis Saint Lucia Saint Vincent
And The Grenadines Samoa San Marino Sao Tome and Principe Saudi
Arabia Senegal Seychelles Sierra
Leone Singapore Slovak
Republic Slovenia Solomon Islands Somalia South
Africa South
Georgia And The South Sandwich Islands Spain Sri
Lanka St Helena St
Pierre and Miquelon Sudan Suriname Svalbard
And Jan Mayen Islands Swaziland Sweden Switzerland Syria Taiwan
Region Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad And Tobago Tunisia Turkey Turkmenistan Turks
And Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United
Kingdom United
States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City State
(Holy See) Venezuela Vietnam Virgin Islands
(British) Virgin Islands (US) Wallis
And Futuna Islands Western Sahara Yemen Yugoslavia Zambia Zimbabwe
Profession:
E-mail:
Adresse
complète:
Tél:
Fax:
Où
voudriez-vous
prendre votre visa?
Australia-ACT
Austria-Vienna
Azarbaijan-Baku
Bahrain-Manama
Canada-Ontario
China-Beijing
Denmark-Copenhagen
France-Paris
Germany-Bonn
Germany-Frankfurt
Germany-Hamburg
Germany-Munich
Greece-Athens
India-New Delhi
India-Mumbai
(Bambay)
India-Hyderabad
Iraq-Baghdad
Ireland-Dublin
Italy-Rome
Italy-Milan
Japan-Tokyo
Jordan-Amman
Kuwait-Kuwait
Lebanon-Beirut
Netherlands-The
Hagur
New
Zealand-Wellington
Pakistan-Islamabad
Pakistan-Karachi
Pakistan-Lahore
Pakistan-Peshawar
Pakistan-Quwtta
Qatar-Diplomatic
Area
Russia-Moscow
Saudi Arabia-Riyadh
Spain-Madrid
Sweden-Stockholm
Switzerland-Berne
Switzerland-Geneva
Syria-Damascus
Thailand-Bangkokt
Turkey-Ankara
Turkey-Istanbul
United
Arab Emirates (UAE)-Abu Dhabi
United
Arab Emirates (UAE)-Dubai
United
Kingdom-London
United
States of America-Washington
Yemen-San’a
Date d'Entrée (jj/mm/aaaa):
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/
JAN
FEB
MAR
APR
MAY
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JUL
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SEP
OCT
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/
2008
2009
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2011
2012
NO. de vol:
Date de Sortie
(jj/mm/aaaa):
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/
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
/
2008
2009
2010
2011
2012
Nom de compagnie aérienne:
Durée de
demande de visa:
Quelles villes voudriez-vous visiter?
Informations
de passeport
N°. de
Passeport:
Date de délivrance (jj/mm/aaaa):
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/
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
/
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Date
d'expiration (jj/mm/aaaa):
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28
29
30
31
/
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
/
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Lieu de
délivrance:
Avez-vous
encore visité l'Iran:
L'Image de première page du passeport:
Pour plus
d'information, lisez notre
FAQ
and TOS enregistrement.
