saqarTvelo

sagareo saqmeTa saministro

GEORGIA

foto

Ministry of Foreign Affairs

savizo anketa/ VISA APPLICATION
gvari, saxeli
Full name
----------------------------sxva gvarebi
Other names ----------------------------dabadebis adgili, dRe, Tve, weli
Day, month, year and place of birth ---------------------

1.
2.
4.

----------------------------------------------------------------------5.
moqalaqeoba
Citizenship ---------------------------------------------(ormagi moqalaqeobis SemTxvevaSi miuTiTeT
orive / In case of dual citizenship, please indicate both)

mudmivi sacxovrebeli adgilis misamarTi

8.

Permanent address -----------------------------------------------------------------------------------------------------------------9. sad muSaobT, Tqveni Tanamdeboba

Where do you work, your position -------------------------------

3.

PHOTO

sqesi / Sex

a) mamrobiTi
a) Male

b) mdedrobiTi
b) Female

pasportis
Passport
No ------------------------------------7.
pasportis tipi
Type of passport
a) diplomatiuri
a)
Diplomatic
6.

b) samsaxurebrivi
b)
Service
g)
c)

ordinaluri
Ordinary

d) samgzavro dokumenti
d)
Travel document

----------------------------------(daazusteT/please specify)

---------------------------------------------------------------------10. meuRle, arasrulwlovani Svilebi

Spouse, Children under 16 years old -----------------------------------------------------------------------------------------------------------(gvari, saxeli, dabadebis TariRi, moqalaqeoba Full name, date of birth, citizenship)

-----------------------------------------------------------------------------------------------------------------------------------------------------------(es punqti SeavseT im SemTxvevaSi, Tu zemoT miTiTebuli pirebi Cawerilni arian Tqvens pasportSi da mogzauroben TqvenTan erTad
/Fill this section if the indicated persons are included on your passport and travelling with you)

11.

saqarTveloSi momwvevi organizaciis an kerZo piris saxeli, gvari, misamarTi da tel.

Name, address and telephone of the inviting institution, or person -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------12. Tqveni misamarTi saqarTveloSi yofnis periodSi ----------------------------------------------------------------------------------Your address, during your stay in Georgia---------------------------------------------------------------------------------------13. iyaviT Tu ara micemuli sisxlis samarTlis pasuxisgebaSi romelime qveyanaSi
Have you ever been sentenced for criminal offence in any country
14. saqarTveloSi mgzavrobis mizani
Purpose of your visit to Georgia
a) oficialuri
b) saqmiani
g) kerZo
a) Official
b) Business
c) Private

diax

yes

ara

No

16. saqarTveloSi yofnis savaraudo vada:

Length of intended stay in Georgia:
a)
dRe b)
Tve
g)
weli
a) ---------days b) ---------month(s)
c) -----------year

d) turistuli
d) Tourism

e) sxva
17. Sesvlis TariRi
e) Other ---------------------------------Date of entry ---------------------------------------------(daazusteT/ specify)
18. gasvlis TariRi
15. pasportis moqmedebis vada
Date of departure ------------------------------------Validity of passport
-------------------------------19. Sesvla-gasvlis odenoba
a) erTi
b) ori
g) mravaljeradi
Number of entries
a) one
b) Two
c) Multiple
vacxadeb, rom anketaSi miTiTebuli monacemebi sworia

I declare, that the information given in this application is correct

TariRi
Date ------------------------------------piradi xelmowera
Personal signature----------------------