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VisaHQ.com Inc. Embassy Row 2005 Massachusetts Ave. NW Washington, DC 20036 (800)345-6541

Burkina Faso Tourist visa Application Please enter your contact information Name: Email: Tel:

Mobile:

The latest date you need your passport returned in time for your travel:

Burkina Faso tourist visa checklist Filled out and signed Burkina Faso tourist visa application form. The form is enclosed. Original Passport. Passport must have at least 6 months remaining validity and have at least 1 visa page. 2 Photographs. Standard passport photographs 2x2 inches on a white background. Payment. Credit Card Authorization form, Certified Check, or Money Order payable to VisaHQ.com. Return mailer. Prepaid self-addressed return label or payment for FedEx.

If you wish to prepay return shipping, please add the shipping fee to the total and provide return address: FedEx 2nd day delivery - From $16

Name:

FedEx Standard Overnight - From $22

Company:

FedEx Priority Overnight - From $26

Address:

FedEx First Overnight - From $55 FedEx Saturday delivery - From $60 Prepaid self addressed mailer - $0 Local pick up in Washington - $0

City: State:

Zip:

* Actual prices may vary based on location per FedEx.com.

VisaHQ.com Inc., Embassy Row 2005 Massachusetts Ave. NW , Washington, DC 20036 T: (202)558-2216

E: [email protected]

Mail documents to:

Tel:

VisaHQ.com Inc. Embassy Row 2005 Massachusetts Ave. NW Washington, DC 20036 (800)345-6541

Proof of status. Copy of Green Card (both sides) or other proof of legal status in the US (such as copy of I-20, US visa, H1B approval notice, etc. VisaHQ cannot assist US B1/B2 visa holders at this time.) Yellow Fever Vaccination. A copy of the International Certificate of Vaccination (ICV) for yellow fever. To learn more about the yellow fever vaccination or to locate a vaccination clinic, please visit the CDC's yellow fever resource page.

VisaHQ.com Inc., Embassy Row 2005 Massachusetts Ave. NW , Washington, DC 20036 T: (202)558-2216

E: [email protected]

Mail documents to:

Tel:

VisaHQ.com Inc. Embassy Row 2005 Massachusetts Ave. NW Washington, DC 20036 (800)345-6541

Burkina Faso tourist visa fees for citizens of Belgium living in Alabama Type of visa

Validity

Processing time

Embassy fee

Service fee

Total

Multiple entry

up to 180 days

3 business days

$175.00

$99.00

$274.00

Multiple entry

up to 180 days

Next business day

$225.00

$149.00

$374.00

Multiple entry

up to 365 days

3 business days

$220.00

$99.00

$319.00

Multiple entry

up to 365 days

Next business day

$270.00

$149.00

$419.00

This order is subject to Terms of Service, posted on VisaHQ website. All fees and requirements may change without notice.

VisaHQ.com Inc., Embassy Row 2005 Massachusetts Ave. NW , Washington, DC 20036 T: (202)558-2216

E: [email protected]

Mail documents to:

VisaHQ.com Inc. Embassy Row 2005 Massachusetts Ave. NW Washington, DC 20036

Tel:

(800)345-6541

Credit card authorization form By signing this form i accept VisaHQ.com Terms of Service and authorize to charge my credit card for the amount of $ Name on the Credit Card: Credit card number:

-

Exp. date:

/

-

-

Credit Card Billing Address:

Signature:

Comments:

Thank you! We accept all major credit cards.

VisaHQ.com Inc., Embassy Row 2005 Massachusetts Ave. NW , Washington, DC 20036 T: (202)558-2216

E: [email protected]

AMBASSADE DU BURKINA FASO A WASHINGTON D.C. 2340 Massachusetts Ave, D.C 20008 Washington, D.C – USA tél: (202) 332-5577 – fax: (202) 667-1882

Photographie

DEMANDE DE VISA DE TRANSIT OU DE SEJOUR AU BURKINA FASO

N°______/AMBF/WASH Informations du demandeur

du……/……/……

Nom (en lettre capitale) : ………………………………………………………………................................................. Name

Née (Nom de jeune fille) : …………………………………………………………………………………………………… Maiden name

Prénoms : ……………………………………………………………………………………………………………………… Given names

Né(e) le : …. / …. / …….. (JJ/MM/AAAA) à …..………………………………………………….. Sexe : M

F

Sex

Date of birth (dd/mm/yyyy)

Nationalité d'origine : ………………………………………………………………………………………………………… Place of birth

Nationality of origin

Nationalité actuelle : …………………………………………………………………………………………………………. Nationality

Situation de famille : ……………………………………………… Nombre d'enfants : ………………………..……..….. Relationship status

Number of children

Adresse du demandeur : ………………………………………………………………………………….…………………. Address

Contact : ……………………………………………………………………………………………………………………….. Phone number

Profession : ……………………………………………………………………………………............................................ Occupation

Informations Visa Transit

à destination de : ……………………………… date d’arrivée : ……/……/………………………

Transit

Going to

Arrival date

Séjours

durée du séjour : …………………….

Nombre d’entrées :

Stay

Length of the stay

Une……

Multiples

Number of entrance

Motif du voyage : …………………………………………Type du visa:………………………………………………….. Purpose of travel

………………………………………………………………………………………….………………..……………………… Lieu(x) de destination : ……………………………………………………………………..………………………………… Destination

………………………………………………………………………………………............……………..…………………… Adresse au Burkina Faso : ……………………………………………………………..…………….....…………………… Address in Burkina

Contact : ……..…………………………………………………………………………..……………….…………………… Phone number

Informations Passeport N° du passeport : …………………..

Date d'expiration : …. / …. / …….. (JJ/MM/AAAA)

Passport number

Validity date (dd/mm/yyyy)

Délivré le : …. / …. / …….. (JJ/MM/AAAA)

par : ……………………………….……………………………………………

Issued date (dd/mm/yyyy)

Place of issue

Fait à……………………, Le …. / …. / …….. At

(JJ/MM/AAAA)

Signature du demandeur Signature