T.C.

Dışişleri Bakanlığı
Republic of Turkey, Ministry of Foreign Affairs Visa Application Form

Personal information

Name : SALMA Date of birth : 30.9.1993

Surname
Gender
Current citizenship : Morocco
Town/City of birth : AGDAL
Country of birth
: ALAMI MEJJATI Marital status : Single
: Female Present occupation : Education and Training
Mother’s full name : HASSANIA
Father’s full name : CHAKIB
: Morocco Reference Number : 297138812823494

Passport information
Type of travel document : Ordinary Passport Issue date : 5.8.2022
Passport number : RC9210793 Expiry date : 5.8.2027
Issuing authority : PREFECTURE DE FES Place of issue : Fas

Contact information
Personal Address: Professional Address:

CUMHURİYET MAHALLESİ ŞEHİT PİLOT ÜSTEĞMEN

192 RUE ABOU SHITAE JAMAI HAY ADARISSA FES/MAR
ERDEM ÖZTÜRK SOKAK NO:12 MERKEZ/ÇANKIRI

City: FES Country: Morocco City: ÇANKIRI Country: Turkey

Telephone number : 0661746640 Telephone number :
E-mail address : samia.alami_54@icloud.com E-mail address : deuam@karatekin.edu.tr

About your travel

Type of visa : Student/Education Visa Number of entries requested: Single Entry
Purpose of travel : Turkish Language Course Purpose Duration of stay : 90 days
Date of entry : 14.1.2023
Means of transport : Air
Date of departure : 14.4.2023
Who is covering the costs of your travel to Turkey? Host company
Name: ÇAKÜ DİL EĞİTİMİ UYGULAMA VE
Email: Deuam@karatekin.edu.tr
ARAŞTIRMA MERKEZİ
Name of host person or
CUMHURİYET MAHALLESİ ŞEHİT
host company:
Address: PİLOT ÜSTEĞMEN ERDEM ÖZTÜRK Telephone:
SOKAK NO: 12 MERKEZ/ÇANKIRI
Do you have any travel and/or health insurance for your travel to Turkey? Yes Valid until: 14.12.2023
I certify that I have read and understood all the questions set forth in this application form and the answers I have furnished on this form are true and correct to the best
of my knowledge and belief. I understand that possession of a visa does not automatically entitle me to enter the Republic of Turkey upon arrival at a port of entry.
If I fail to comply with the relevant provisions of the Turkish Passport Law No: 5682 and Law on Foreigners and International Protection No:6458, my entry will be refused and in
case of refusal, I will not claim any compensation.
Place and date Signature
12.1.2023 SALMA ALAMI