Inicio | MIREX | Contactos
 
Delegaciones Consulares en Su País
Gobierno Dominicano | Instituciones Dominicanas | Noticias Consulares  | Directorio

Visa Application Form
1. Surnames
1.1 Surnames
1.2 Other surnames used (married, maiden, etc)
 
2. Names
2.1 First and middle names
2.2 Other names (religious, professional, etc)
3. Birth and Nationality Information
3.1 Country 
3.2 Province/State
3.3 District/City
spacer
3.4 Date of birth (dd/mm/yy)
3.5 Country of Nationality
3.6 Second Nationality
4. Sex, Occupation and Education
4.1 Sex  
4.2 Highest academic dregree obtained
4.3 Occupation
5. Current location
5.1 Country
5.2 Province/State
5.3 District/City
spacer
5.4 Type of Thoroughfare
5.5 Name
5.6 No.
5.7 Floor
5.8 Staircase
5.9 Door No.
5.10 Postal Code
 
spacer
5.11 Home Phone Number
5.12 Mobile Phone
5.13 Business Phone Number
5.14 Fax Number
5.14 E-Mail Address
6. Passport Information
6.1 Number
6.2 Country of Issue
6.3 City of issue
6.4 Place where passport was issued
spacer
6.5 Issuing country
6.6 Date of Issue (dd/mm/yy)
6.7 Date of expiry (dd/mm/yy)
7. Identity Documents
7.1 Country of issue
7.2 Type of Document
7.3 Number
7.4 Date of expiry (dd/mm/yy)
spacer
7.1 Country of issue
7.2 Type of Document
7.3 Number
7.4 Date of expiry (dd/mm/yy)
8. Personal Status and Spouse Information
8.1 Marital Status
 
8.2 Full name of spouse (even if divorced)
8.3 Spouse's Date of Birth (dd/mm/yy)
9. Length of stay in the Dominican Republic and purpose of visit
9.1 On what date do you plan to travel? (dd/mm/yy)
9.2 How long do you intend to stay?
9.3 What is the purpose of the visit?
9.4 Other
10. Name and location where you stay in the Dominican Republic
10.1 Name (Hotel or Person)
10.2 Phone Number
10.3 Mobile Phone Number
10.4 In Which Province?
10.5 In which district or city?
spacer
10.6 Sector or Neighborhood?
10.7 Type of street
10.8 Name of street
10.9 Number
10.10 Postal Code
11. Employment or place of study information
11.1 Activity
11.2 Name of the Institution
11.3 Phone Number
11.4 Address
spacer
12. Other than yourself, will anyone pay for your travel expenses?
12.1 Name
12.2 Relationship
spacer
13. Have you ever visited the Dominican Republic? (If yes answer the following questions starting with the most recent visit)
13.1 In what date (dd/mm/yy)?
13.2 Length of stay
spacer
                 
14. Have you even been issued a visa to enter the Dominican Republic? (If Yes please specify the following information for each visa)
14.1 Date (dd/mm/yy)
14.2 Country of issue
14.3 City
spacer
14.4 Type of Visa
14.5 Number of visa
spacer
 
spacer
spacer
spacer
15. Visas granted by other countries
15.1 Issuing country
15.2 Country where it was issued
15.3 Date of Expiry (dd/mm/yy)
spacer
15.4 Type of Visa
15.5 Number of visa
spacer
15.1 Issuing country
15.2 Country where it was issued
15.3 Date of Expiry (dd/mm/yy)
spacer
15.4 Type of Visa
15.5 Number of visa
spacer
15.1 Issuing country
15.2 Country where it was issued
15.3 Date of Expiry (dd/mm/yy)
spacer
15.4 Type of Visa
15.5 Number of visa
16. Have you ever had a visa for the Dominican Republic cancelled or revoked? 

17. Have you ever been denied a visa for the Dominican Republic?
(If Yes please answer the following questions)
17.1 Date (dd/mm/yy)
17.2 Country
17.3 City
spacer
17.4 Clase de Visa
spacer
17.1 Date (dd/mm/yy)
17.2 Country
17.3 City
spacer
17.4 Clase de Visa
18. Do you intend to work or study in the Dominican Republic?
18.1 Type of Activity
18.2 Name (person, business or educational institution
18.3 Telephone
18.4 Address
spacer
18.1 Type of Activity
18.2 Name (person, business or educational institution
18.3 Telephone
18.4 Address
19. Has anyone ever applied for a visa on your behalf?
(If yes, please specify who and your relationship with that person)
19.1 Name (company or person)
19.2 Relationship / Kinship
spacer
19.1 Name (company or person)
19.2 Relationship / Kinship
20. Names of the people who will accompany you
20.1 Names
20.2 Relationship / Kinship
spacer
20.1 Names
20.2 Relationship / Kinship
spacer
20.1 Names
20.2 Relationship / Kinship

Portal de Servicios Consulares de la República Dominicana
Ministerio de Relaciones Exteriores (MIREX)
® Derechos Reservados.