Burkina Faso Tourist visa Application for citizens of Bangladesh living in Alberta

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1 Burkina Faso Tourist visa Application for citizens of Bangladesh living in Alberta Please enter your contact information Name: 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. Passport Photos: 2 photos. Photo size MUST be 5x7 cm, with first and last name written on back. Payment. Credit Card Authorization form, Certified Check, or Money Order payable to VisaHQ.ca. 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 $33 FedEx Priority Overnight - From $34 FedEx First Overnight - From $54 FedEx Saturday delivery - From $62 Prepaid self addressed mailer - $0 Local pick up in Ottawa - $0 Name: Company: Address: City: State: Posta l code: * Actual prices may vary based on location per FedEx.com.

2 Itinerary. Copy of round trip tickets or itinerary. 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 Health Canada's yellow fever resource centre.

3 Burkina Faso tourist visa fees for citizens of Bangladesh living in Alberta Type of visa Validity Processing time Embassy fee Service fee Money order Fee HST Total Single entry up to 90 days 3 business days $ $69.00 $10.00 $3.45 $ Single entry up to 365 days 3 business days $ $69.00 $10.00 $3.45 $ Multiple entry up to 90 days 3 business days $ $69.00 $10.00 $3.45 $ Multiple entry up to 180 days 3 business days $ $69.00 $10.00 $3.45 $ Multiple entry up to 365 days 3 business days $ $69.00 $10.00 $3.45 $ This order is subject to Terms of Service, posted on VisaHQ website. All fees and requirements may change without notice.

4 Credit card authorization form By signing this form i accept VisaHQ.ca Terms of Service and authorize to charge my credit card for the amount of $ Name on the Credit Card: Credit card number: Exp. date: / CVC: Credit Card Billing Address: Signature: Comments: Thank you! We accept all major credit cards.

5 Nom (en lettre capitale) :... Name Informations du demandeur Née (Nom de jeune fille) :. Maiden name Prénoms : Given names Né(e) le :. /. /.. (JJ/MM/AAAA) à.... Sexe : M Date of birth (dd/mm/yyyy) AMBASSADE DU BURKINA FASO A OTTAWA 48, Chemin Range Ottawa, Ontario Canada, K1N 8J4 tél: (613) fax: (613) DEMANDE DE VISA DE TRANSIT OU DE SEJOUR AU BURKINA FASO Nationalité d'origine : Nationality of origin Nationalité actuelle :. Nationality Situation de famille : Postal code Marital status Une photo au format passeport 7 cm x 5 cm Ne pas scotcher, coller ou agrafer One passport-size photography 2.75 x 2 inches Do not tape, paste or staple Nombre d'enfants : Adresse :...Ville... Address Prov...Code P Pays... Province Contact :.. Phone number Profession :... Occupation Informations Visa Visa demandé : Court séjour Long séjour Diplomatique Coopération Courtoisie Transit Lieu(x) de destination :... Date d arrivée au Burkina Faso :.../... /. Destination Durée du séjour :. Nombre d entrées : Une Multiples Length of the stay Arrival date Motif du voyage :... Purpose of travel Adresse au Burkina Faso :..... Phone number Number of children Contact :..... Address in Burkina Demande N..... du Visa N... Place of birth Number of entries City Country Sex F Transit Informations Passeport Type de passeport : Ordinaire Diplomatique Spécial Autre (préciser) N du passeport :.. Date d'expiration :. /. /.. (JJ/MM/AAAA) Passport number Délivré le :. /. /.. (JJ/MM/AAAA) Validity date (dd/mm/yyyy) Issued date (dd/mm/yyyy) Place of issue par :. Fait à, At Le. /. /.. (JJ/MM/AAAA) Signature du demandeur Signature

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