Stamp of Embassy or

Consulate
Application for Schengen Visa

Photo

This application form is free

FOR EMBASSY /
CONSULATE USE ONLY

2. Surname(s) at birth (earlier family name(s))

Date application :

3. First names (given names)

File handled by :

4. Date of birth (day-month-year)

5. ID-number (optional)

6. Place and country of birth

7. Current nationality/ies

8. Original nationality (nationality at birth)

9. Sex

10. Marital status :

Male
Female
11. Fathers name

Single

Married

Separated

Divorced

Widow(er)

Other

12. Mothers name

13. Type of passport:

National passport

Diplomatic passport
Service passport

Travel document (1951 Convention)

Aliens passport

Other travel document (please specify):

14. Number of passport

15. Issued by

16. Date of issue (daymonth-year)

17. Valid until (day-month-year)

Supporting
documents:
Valid passport
Financial means
Invitation
Means of
transport
Health insurance
Other e.g:
Valid Res. Perm
Letter from
employer
Payslip
Hotel
reservation

Visa :
Refused
Granted
Characteristics of
Visa :
LTV
A
B
C
D
D+C
Number of entries :
1 2
Multiple
Valid
from ..........................
.........................
To ..............................
.....................

18. If you reside in a country other than your country of origin, have you permission to
return to that country?

No

Yes, (number and validity)

*19. Current occupation

Valid for :
...................................
................

*20. Employer and employers address and telephone number. For students, name and
address of school.

DK
The questions marked with * do not have to be answered by family members of EU or EEA citizens (spouse, child
or dependent ascendant).
Family members of EU or EEA citizens have to present documents to prove this relationship.

Page 2 of 6

21. Main destination

22. Type of Visa :

24. Number of entries requested

Single entry
entries

Two entries

23. Visa :
Individual

Transit

Collective

Long stay

FOR EMBASSY /
CONSULATE USE ONLY

25. Duration of stay

Multiple

Visa is requested for: days

26. Other visas (issued during the past three years) and their period of validity

27. In the case of transit, have you an entry permit for the final country of destination?

No

Yes , valid until:

Issuing authority:

*28. Previous stays in this or other Schengen states

29. Purpose of travel

Tourism

Business

Visit to Family or Friends

Cultural/Sports

Official

Medical reasons

Other (please specify):

*31. Date of departure (day-month-year)

*32. Border of first entry or transit route

*33. Means of transport

*34. Name of host or company in the Schengen states and contact person in host company.
If not applicable, give name of hotel or temporary address in the Schengen states
Name
Telephone and telefax

Full address

e-mail address

*35. Who is paying for your cost of travelling and for your costs of living during your stay?

Myself

Host person/s
documentation):

Host company. (State who and how and present corresponding

Page 3 of 6

DK

Page 4 of 6

*36. Means of support during your stay

Cash

Travellers' cheques

Accommodation

Other:

Credit cards

FOR EMBASSY /
CONSULATE USE ONLY

Travel and/or health insurance. Valid until:

39. Spouses first name

38. Spouses family name at birth

40. Spouses date of birth (daymonth-year)

41. Spouses place of birth

42. Children (Applications must be submitted separately for each passport)

43. Personal data of the EU or EEA citizen you depend on. This question should be
answered only by family members of EU or EEA citizens.
Name
First Name

Date of Birth

Nationality

Number of
passport

Family relationship :

of an EU or EEA
citizen
44. I am aware of and consent to the following: any personal data concerning me which appear
on this visa application form will be supplied to the relevant authorities in the Schengen states and
processed by those authorities, if necessary, for the purposes of a decision on my visa application.
Such data may be input into, and stored in, databases accessible to the relevant authorities in the
various Schengen states.
At my express request, the consular authority processing my application will inform me of the
manner in which I may exercise my right to check the personal data concerning me and have them
altered or deleted, in particular, should they be inaccurate, in accordance with the national law of
the state concerned.
I declare that to the best of my knowledge all particulars supplied by me are correct and complete.
I am aware that any false statements will lead to my application being rejected or to the annulment
of a visa already granted and may also render me liable to prosecution under the law of the
Schengen state which deals with the application.
I undertake to leave the territory of the Schengen states upon the expiry of the visa, if granted.
I have been informed that possession of a visa is only one of the prerequisites for entry into the
European territory of the Schengen states. The mere fact that a visa has been granted to me does
not mean that I will be entitled to compensation if I fail to comply with the relevant provisions of
Article 5.1 of the Schengen Implementing Convention and am thus refused entry. The prerequisites
for entry will be checked again on entry into the European territory of the Schengen states.
45. Applicants home address
46. Telephone

number

Page 5 of 6

47. Place and date (day-month-year)

48. Signature (for minors, signature of

DK

Page 6 of 6