THE EMBASSY OF THE UNITED REPUBLIC OF TANZANIA
 
FOR OFFICIAL USE ONLY
GRR NO.___________________
VISA NO.___________________
Ref. NO.____________________
 
1232 22nd St. NW, Washington DC, 20037
Tel. (202) 939-6125 and (202) 884-1080 Fax (202) 797-7408
| VISA APPLICATION FORM | 2 Passport Size | 
| (Visa Regulations on the next page) | 
|   | Photograph | 
|   | Size: 2x2 | 
|   | Do not paste or | 
|   | staple | 
|   |   | 
 
 
1.Surname or Family Name (Mr./Mrs./Miss/Ms/Dr./Prof.)___________________________________
First Names in Full_______________________________________________________________
Former or Maiden Name (if different from above) _______________________________________
2.Date of Birth (DD/MM/YY)_______________________________________Sex (M/F)___________
3.Place of Birth____________________________Country of Birth___________________________
Current Nationality (State if Dual Nationality) ___________________________________________
Nationality at Birth________________________________________________________________
4. Marital Status (Mark):  Single  Married  Divorced  Widowed  Legally Separated.
5.Passport No _________________Date Issued ______________Valid Until ___________________
Issued At ___________________Issuing Authority______________________________________
6.Profession/Occupation_____________________________________________________________
Employer Address: _______________________________________________________________
7.Current Address__________________________________________________________________
Tel.__________________Fax__________________E-mail________________________________
8.Name of Travel Agent/Tour Operator__________________________________________________
9.Contact Person(s) in Tanzania_______________________________________________________
Address_________________________________________________________________________
10.Date of Entry___________________________Depature Date______________________________
| Duration of Stay_________________________ (Max. 90 Days) |   | 
| Type of Visa Requested | Travel Visa | Transit Visa | 
11. Purpose of visit
 
Leisure, Holiday Visiting friends, relatives Mission
Meeting, Conference
 
Other Business
Study
Transit
Health Treatment
 
Various
Diplomatic
Official
Same day visitor
 
 
| 12. | Requested Number of Entries: |  Single |  Double |  Multiple. | 
| 13. | In Case Of Transit: Do you have an Entry Permit for the Final Country of Destination? |  No  Yes Valid Until: | 
14.Budget Available For Your Stay_________________________________
15.I Hereby Declare That The Information Stated Above Is True And Correct :
Signature of Applicant___________________________________________Date________________________________