HOW TO FILL THE SHORT STAY

APPLICATION FORM
You can use any original or photocopy of application form ref. cerfa n 14076*1
print out very clearly or any application form downloaded from internet ;
It must be legibly completed in capital letters dated and signed by the applicant
himself/herself or by parent of legal guardian for below 18 years old ;
All items must be completed thoroughly;
If an item is not applicable to the applicant, he/she writes down the letters S.O. or
N.A.;

1. Surname (Family name) : Write your name as it is indicated on your passport (in case of a maiden
name, write pouse or ne followed by your husbands name)
2. Surname at birth : Write the name that you had at birth if it is different than the one indicated on the
heading # 1
3. First name (s) (given name (s) : Write your first name(s) as indicated on your passport
4. Date of birth 5. Place of birth : Write the 7. Current nationality : Write your
(day-month-year) : Write city where you was born actual nationality followed by any
your date of birth in this order other nationality that you are
(day-month-year) 6. Country of birth : Write possessing
your country of birth Nationality at birth, if different :
nationality of origin
8. Sex : tick the space 9.Marital status : tick the space corresponding to your sex. In case of
corresponding to your sex common law relationship, tick other and write concubinage. In case
of PACS with a french national write PACS
10. In the case of minors: Surname, first name..: If below 18 years of age write surname, first
name address and nationality of parental authority/legal guardian
11. National identity number, where applicable : I D card number (not mandatory)
12. Type of travel document: tick the space corresponding to your type of passport

13. Travel document number: write 14. Date of issue: 15. Valid until: 16. Issued by:
your passport number as indicated on Write the 1st date of write the validity Precise the
your passport. (Ensure that your entry and not the indicated, if it was administration
passport contains at least 2 blank pages. extended date extended write who issued
These 2 blank pages must not have any this last date your passport
stamps or visa at the back of them)
17. Applicants home address and e-mail address: write Telephone number(s): write your fixe
clearly your actual complete postal address and your and mobile telephone numbers in your
e-mail address actual country of residence
18. Residence in a country other than the country of current nationality: tick the appropriate
space. If you tick yes write the number and the date of validity of this document, stamp or visa. If this
permit is a stamp or a visa on your passport, give the photocopy of this page. If this permit is printed on
a separate document present the original and the photocopy
* The fields marked with * do not need to be filled in by family members ( spouse, child below
18 years or dependent ascendant) of European nationals

(x) Field 1, 2 and 3 shall be filled in accordance with the data in the passport (travel document)

*19. Current occupation: write your actual duty or position or profession. If different than the one
indicated on the passport, write actual profession followed by ex-student, or retired followed by
ex-......... If employed present job letter. If self employed present proof of existence of your business
with proof of the type of business.
*20. Employer and employers address and telephone .: Write the name, address, e-mail, telep.
number of employer. If self-employed, write self-employed, if retired write ex- followed by former
profession
21. Main purpose of the journey: Tick appropriate box. Present document appropriate to the purpose
22. Member State(e) of destination: write the country or 23. Member State of 1st entry: write
countries in the Schengen State(e), French Department, the 1st Schengen States or French
Territories or Colonies which you want to visit. Present the Department, Territories or Colonies in
travel itinerary for the total journey from your country of which you will enter or transit.
residence to the destination in the Schengen State with return.
24. Number of entries request: tick 25. Duration of the intended stay: write how many days
appropriate box you are requesting to visit or to transit in the Schengn State(s)
or Departments, Colonies or Territories. This information must
coincide with your proof of accommodation and your travel
itinerary
26. Schengen visas issued during the past 3 years: tick the appropriate box. If you tick yes indicate
the dates and give photocopies of these visas
27. Fingerprints collected previously: tick appropriate box. If you tick yes, write date, if known or
simply write the year
28. Entry permits for the final country of destination, where applicable: Fill this space only if you
do not have the nationality of your country of residence and present your visa or your permit with a
photocopy
29. Intended date of arrival in the Schengen 30. Intended date of departure..: write the
State: write your date of arrival in the Schengen date of your departure from the Schengen State, or
state, French Department, according to your French Department according to your travel
itinerary itinerary
31. Surname and first name of the inviting personIf not applicable, name of hotel(s)or other
temporary accommodation: Write the full name of inviting party, or hotel or guest houseetc as
indicated on the document or on the hotel or guest house booking
Address and e-mail of inviting personhotel: write the Telephone: write fixe, mobile
complete postal address as indicated on invitation or on the proof telephone number of inviting
of accommodation or on the hotel, guest house booking partyhotel
32. Name and address of inviting company: write name of Telephone: write fixe, mobile
company or organization who invited you as indication on telephone number of inviting
invitation or on the official proof of accommodation party
Surname, first name, address .: write all details of contact person from the company or
organization who invited you as indicated on your invitation
33. Cost or traveling and living during the applicant stay: Concerning the means of support, tick
the appropriate space. Must present document to prove the means of support.
Tick appropriate space for the means of support Tick appropriate space if means of support
provided by applicant provided by inviting party or any other third party
34. Personal data of the family member who is an EU, EEA, or CH citizen. Data of applicants
European spouse, parent (if applicant is below 18 years), or applicant child ( if applicant is a
dependent)
Surname : write surname of this European family First name :write the first name of this European
family
Date of birth: write the Nationality: write the Number of travel document or ID
date of birth of this nationality of this European card: write the passport number or the
European family family ID card number of this European family.
This information is not mandatory
35. Family relationship with an EU, EEA or CH citizen: family relationship with a European
national. Tick appropriate space
36. Place and date : Signature (for minors, signature of parental authority / legal guardian) :
write your town or Applicants signature.
your actual location at If applicant is below 18 years of age, parent or legal guardian signature with
the Embassy and the presentation of original + photocopy of his/her identification + original and
date photocopy of childs birth certificate + completed consent form
I am aware that the visa fee is not refunded if the visa is refused.
Applicable in case a multiple-entry..
I am aware of the need to have an adequate travel medical insurance for my first stay and any
subsequent visits to the territory of Member States.
I am aware of and consent to the following: the collection of the data..

Read carefully all the information written at the bottom of the application form.
Place and date: Signature (for minors, signature of parental
After knowledge of all the above information, authority / legal guardian.
write the place and the date Sign after knowledge of all the above information