"Kyrgyz Visa Application Form" - Kyrgyzstan (English/Kyrgyz)

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Download "Kyrgyz Visa Application Form" - Kyrgyzstan (English/Kyrgyz)

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Kyrgyz Republic
VISA REQUIREMENTS AND INSTRUCTIONS
READ CAREFULLY: Incomplete or delayed submission of the visa
application can result in you missing your program!
To apply for your visa:
Use the one-page visa application form contained in this document.
Please provide type-written responses for the visa application form, following
the instructions below:
1.
Enter your full name as it appears on your passport. This name MUST match the name you
used for your Peace Corps passport application.
2.
Enter U.S.A. as your citizenship. If applicable, please list any additional citizenships only if you
have a current, valid citizenship in another country besides the United States.
3.
List your sex (Male or Female).
4.
Enter your date of birth, listing the day first (DD-MM-YYYY). For example, if your birthday is
March 24, 1988, you will enter 24-03-1988. Enter place of birth as city and state if born in the
United States (i.e. New York, New York) or as city and country if born outside the U.S. (i.e.
Tokyo, Japan).
5.
Leave this field blank. Do NOT enter a personal identification number.
6.
List your current mailing address and phone number.
7.
List your current employer and work address. If you are a student or unemployed, list Peace
Corps Volunteer, 1111 20
th
St. NW, Washington, DC 20526
8.
Enter the highest degree you have achieved. If you are a current undergraduate student, enter
the degree you expect to obtain at graduation prior to your Peace Corps service.
9.
Enter Peace Corps Volunteer as the purpose of your visit.
10.
Leave this field blank. Do NOT enter the number and validity of your travel document. We will
fill this in with your no-fee Peace Corps passport number once it is ready.
11.
Enter 304 Chokmorov Street, 720010 Bishkek, Kyrgyz Republic as the place of stay.
12.
Enter Bishkek as places of visit.
13.
Enter 20 August 2018 as date of entry.
14.
Enter 02 November 2020 as date of departure.
15.
If you have visited Kyrgyzstan before, enter the dates of your previous trips. If you have never
been to Kyrgyzstan, enter None.
Kyrgyz Republic
VISA REQUIREMENTS AND INSTRUCTIONS
READ CAREFULLY: Incomplete or delayed submission of the visa
application can result in you missing your program!
To apply for your visa:
Use the one-page visa application form contained in this document.
Please provide type-written responses for the visa application form, following
the instructions below:
1.
Enter your full name as it appears on your passport. This name MUST match the name you
used for your Peace Corps passport application.
2.
Enter U.S.A. as your citizenship. If applicable, please list any additional citizenships only if you
have a current, valid citizenship in another country besides the United States.
3.
List your sex (Male or Female).
4.
Enter your date of birth, listing the day first (DD-MM-YYYY). For example, if your birthday is
March 24, 1988, you will enter 24-03-1988. Enter place of birth as city and state if born in the
United States (i.e. New York, New York) or as city and country if born outside the U.S. (i.e.
Tokyo, Japan).
5.
Leave this field blank. Do NOT enter a personal identification number.
6.
List your current mailing address and phone number.
7.
List your current employer and work address. If you are a student or unemployed, list Peace
Corps Volunteer, 1111 20
th
St. NW, Washington, DC 20526
8.
Enter the highest degree you have achieved. If you are a current undergraduate student, enter
the degree you expect to obtain at graduation prior to your Peace Corps service.
9.
Enter Peace Corps Volunteer as the purpose of your visit.
10.
Leave this field blank. Do NOT enter the number and validity of your travel document. We will
fill this in with your no-fee Peace Corps passport number once it is ready.
11.
Enter 304 Chokmorov Street, 720010 Bishkek, Kyrgyz Republic as the place of stay.
12.
Enter Bishkek as places of visit.
13.
Enter 20 August 2018 as date of entry.
14.
Enter 02 November 2020 as date of departure.
15.
If you have visited Kyrgyzstan before, enter the dates of your previous trips. If you have never
been to Kyrgyzstan, enter None.
16.
Enter Peace Corps as the inviting party.
17.
Enter
KyrgyzRepublic@peacecorps.gov
as the email address and 202-692-1264 as the
phone number.
18.
Enter Official as the type of visa. Do not enter any other information.
Before printing, confirm you have entered all fields correctly.
Print 1 completed visa form.
Sign and date the visa form.
Attach 1 passport size color photograph (2x2 inches) to your visa application
using a paperclip. This is in addition to the 2 photos needed for your passport
application.
Mail your visa application together with your Peace Corps no-fee passport
application. You need to use a mailing service to send us your travel
documents (i.e. DHL, UPS, or Fed Ex). Please remember to retain your
tracking number. DO NOT use the US Postal Service or your documents may
be destroyed upon arrival at our office as everything that arrives to a federal
building from USPS goes through a heat scanning process.
Peace Corps Headquarters
CWT SATO Travel
1111 20th Street NW
Washington, DC 20526
Call CWT Sato Travel at 202-692-1170 or email at
pcdocuments@cwtsatotravel.com
with any questions regarding your passport or visa applications.
Сүрөт/
КЫРГЫЗ РЕСПУБЛИКАСЫНЫН ТЫШКЫ ИШТЕР МИНИСТРИЛИГИ
Photo
MINISTRY OF FOREIGN AFFAIRS OF THE KYRGYZ REPUBLIC
ВИЗАЛЫК АНКЕТА /VISA APPLICATION FORM
1.
Толук аты-жөнү/Full name
2.
Жарандыгы/Citizenship
3.
Жынысы/Gender
4.
Туулган датасы жана жери/Date and place of birth
5.
Жеке идентификациялык номери, эгерде бар
болсо/Personal identification number, if available
6.
Туруктуу жашаган жери, дареги, тел./Place of permanent
stay, address, ph.
7.
Иштеген жери жана дареги, ээлеген кызматы/Place of
work and address, occupation
8.
Билими/Education
9.
Баруу максаты/Purpose of visit
10.
Документтин №, колдонулуу мөөнөтү, /Number and
validity of travel document
11.
Кыргыз Республикасында жашай турган дареги/Places
of stay in the Kyrgyz Republic
12.
Бара турган жерлер/Places of visit
13.
Кирүү датасы/Planning date of entry
14.
Чыгуу датасы/Planning date of departure
15.
Кыргызстанга кирген/чыккан даталар (акыркы 3 жолу)/
Dates of your trips to Kyrgyzstan (last 3 trips)
16.
Чакырган тарап/Inviting party
17.
Электрондук почтанын дареги, тел./email andph.
18.
Суралуучу визанын категориясы жана түрү/applied
category and type of visa
Анкетада көрсөтүлгөн маалыматтын туура экендигин ырастайм/I declare that the provided information
is truthful.
Эгерде анкетада көрсөтүлгөн маалымат туура эмес болсо, мен толук юридикалык жоопкерчиликти
тартам/If the information provided in the application will be found false, I will take legal responsibility for it.
Кыргыз Республикасынын аймагында жүргөнгө жетиштүү акча каражатынын бар экендигин
далилдейм/I declare that I have sufficient funds for staying in the Kyrgyz Republic.
Датасы/Date 20__ -ж./y ________
Колу/signature ___________
Кызматтык белгилер үчүн визалык чаптаманын орду
(визалык чаптаманын жумушчу бөлүгү)
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