AVATS

Your application is held online for a period of 30 days. During this period, it can be retrieved back any time using the transaction number
provided below:
Your unique transaction number is -
Visa Details

What type of visa are you applying for? Short Stay (C) or Long Stay
(D)
Journey Type: Single or Return

What is the reason for travel?

Purpose of Travel

Passport Type:

Passport/Travel Document Number:

Proposed dates you wish to enter and leave Ireland: From: To:
Personal Details
Surname:

Forename:

Other Name:

Date Of Birth:

Gender:

Nationality

Current Location:
Current Address:

Address Line 1

Address Line 2:

Address Line 3:

Address Line 4:

Contact Phone:

Contact Email:
General Information
Length of residence: No Of Years: No Of Months:

Do you have permission to return to that country after your stay in Ireland? Yes or No
Have you applied for an Irish Visa before? Yes or No
Have you ever been issued an Irish Visa? Yes or No
Please provide location of application or reference number:
Have you ever been refused an Irish Visa? Yes or No
Please provide location of application or reference number:
Have you ever been in Ireland before? Yes or No
Do you have family members living in Ireland? Yes or No
Surname/Family Name (as in Passport):
Forenames:
Date Of Birth:
Relationship to you:
Department of Justice Reference number of family member:
Have you ever been refused permission to enter Ireland before? Yes or No
Have you ever been notified of a deportation order to leave Ireland? Yes or No
Have you ever been refused a visa to another country? Yes or No
Have you ever been refused entry to, deported from, or otherwise required to leave Yes or No
another country?
If yes to any of the above please give details
Have you any criminal convictions in any country? Yes or No
Passport Details
Passport/Travel Document Number:
Type of Travel Document:
Issuing Authority/Type:
Date of Issue:

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Date of Expiry:
Is this your first Passport?
1. Passport/Travel Document Number:
Issuing Authority:
Date of Issue:
Date of Expiry:

2. Passport/Travel Document Number:

Issuing Authority:
Date of Issue:
Date of Expiry:
Employment/College Details
Are you currently employed in your country of residence? Yes or No
Current Employer:
Duration of Employment:
Position Held:
Work Address:
Employer’s Phone Number:
Employer’s Email Address:
Are you currently a student in your country of residence? Yes or No
Name of School/College:
Address:
Phone Number:
Email:
Are you travelling with others
Will you be travelling with any other person? Yes or No
Person 1(or Group Leader) Relationship: Name:

Person 2
Relationship:
Name:
Person 3
Relationship:
Name:

Person 4
Relationship:
Name:
Contact / Host in Ireland
Contact details for Contact / Host in Ireland.
If you have no personal contact/host please give accommodation name and address.
Address Line 1:
Address Line 2:
Address Line 3:
Address Line 4:
Contact Phone:
Is the contact/host in Ireland personally known to you (e.g: family / Friends) Yes or No
Surname/Family Name(as in passport):
Forename:
Country of Citizenship:
Occupation:
Relationship To Applicant:
Department of Justice Reference number(for non-EEA nationals):

Personal Status:
Spouses/Partners details:
Surname / Family Name(as in passport):
Forenames(as in passport):
Other Name(s)(Maiden or name at birth):
Date of Birth:
Passport Number:
Gender:

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In what country does your spouse/partner currently live?

Is your spouse/partner travelling with you? Yes or No
If yes, on applicant's passport? Yes or No
Children Details
How many dependant children do you have?
Please provide the details of any dependant children.
Child 1
Surname:
Forename:
Date Of Birth:
Gender:
Nationality:
Is this child travelling with you?
If yes, on applicant's passport?
Child 2
Surname:
Forename:
Date Of Birth:
Gender:
Nationality:
Is this child travelling with you?
If yes, on applicant's passport?
Child 3
Surname:
Forename:
Date Of Birth:
Gender:
Nationality:
Is this child travelling with you?
If yes, on applicant's passport?
Child 4
Surname:
Forename:"
Date Of Birth:
Gender:
Nationality:
Is this child travelling with you?
If yes, on applicant's passport?
Child 5
Surname:
Forename:
Date Of Birth:
Gender:
Nationality:
Is this child travelling with you?
If yes, on applicant's passport?
Child 6
Surname:
Forename:
Date Of Birth:
Gender:
Nationality:
Is this child travelling with you?
If yes, on applicant's passport?
Agency Details
Did you receive any assistance in completing this form from an agent/agency? Yes or No
Name of Agent:

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Name of Agency:
Address Line 1:
Address Line 2:
Address Line 3:
Contact Phone:

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