PHOTO

IMMIGRATION FORM № 

REPUBLIC OF SIERRA LEONE
VISA APPLICATION FORM

Embassy of Sierra Leone		
2 passport-sized photographs should be attached	
Surname: Mr./Mrs./Miss		
Christian or Other Name		
Sex:	
F

M

Marital status		Married/Single/Divorced		
Present Address		Telephone		
Home Address		
Place of Birth		Date of Birth		
Nationality		
Occupation		
Name and address of Employer		
Passport №		Date of Issue		
Place of Issue of Passport		
Date of Expiry of Passport		
Purpose of visit		
Proposed date of arrival in Sierra Leone		
Approximate duration of stay		
Name of reference in Sierra Leone		
Proposed address in Sierra Leone		
Number and date of the following vaccination certificate: 	
Smallpox		Yellow Fever		
Cholera				
Bank reference (or if none, proof of sufficient means of maintenance) 	
	
Date		Signature of Applicant		
				
	FOR OFFICIAL USE			
Reference number of approval from Immigration Headquarters	
Freetown (if necessary)		
Work Permit № (if necessary)		
Visa №/Entry Permit №		
Valid up to:		
Fee paid (if any)		
General Receipt №, and date of Issue		

	
	Signature & Title of Issuing Officer