VISA APPLICATION FORM

 1.	SURNAME:____________________________________________________________

 2.	OTHERNAMES:_________________________________________________________

 3.	PLACE AND DATE OF BIRTH:____________________________________________

 4.	NATIONALITY AT BIRTH:_______________________________________________

 5.	PRESENT NATIONALITY AND HOW OBTAINED (IF DIFFERENR From #4 Above)

 	____________________________________________________________________

 6.	NAMES AND NATIONALITIES OF
 (A)	FATHER: ____________________________________________________________
 (B)	MOTHER: ____________________________________________________________

 7.	PROFESSION/OCCUPATION: _____________________________________________

 8.	PRESENT ADDRESS: ___________________________________________________

 9.	MARITAL STATUS  (MARRIED, SINGLE, DIVORCED): _______________________

10.	PURPOSE OF PROPOSED VISIT TO THE GAMBIA: ___________________________

11.	APPROXIMTE DATE OF PROPOSED ENTRY: _________________________________

12.	DURATION OF PROPOSED ENTRY: ________________________________________

13.	INTENDED ADDRESS IN THE GAMBIA: ____________________________________

14.	FINANCIAL MEANS AT APPLICANT'S DISPOSAL: ___________________________

15.	PASSPORT NO. _______________________________________________________

16.	ISSUED AT: _________________________________________________________

17.	DATE OF ISSUE: _____________________________________________________

18.	DETAILS OF ANY PREVIOUS VISITS TO THE GAMBIA: ______________________

19.	REFERENCES IN THE GAMBIA: __________________________________________
 (A)	____________________________________________________________________
 (B)	____________________________________________________________________

20.	CONTACT PHONE NO.: _________________________________________________

			SIGNATURE:_____________________________________________
				DATE:__________________________________________