Single Entry - $60.00
Multiple Entries - $100.00
Single Entry (Rush) - $100.00
Multiple Entries (Rush) $200.00
(Pay by money order.
Pers
onal checks are not accepted)
Affix passport
Picture here
Please check applicable box
For Official Use
Visa No.: _______________________________
Type of Visa: ____________________________
Date of Issue: ____________________________
Charges: _______________________________
Issuing Officer: ___________________________
Application for Ghana Entry Permit/Visa
Embassy of Ghana, 3512 International Drive NW - Washington DC 20008
Website: www.ghanaembassy.org
Tel: (202) 686-4520
______________________________________________________________________________________________________
INSTRUCTIONS:
1. This form must be completed in duplicate and in capital letters
and submitted (together with two(2) recent passport-
size pictures) at least Four
teen (14) days before the intended date of departure.
2. Full names and addresses of references/hotel (place of stay) in Ghana should be stated (including telephone numbers, if
available).
3. Any information stated on the form and subsequently found to be incorrect may render entry permit/visa void.
4. Applicants applying by post/mail should provide trackable return self-addressed envelopes.
______________________________________________________________________________________________________
1. (a) Surname:___________________________________ First Name (s): ___________________________________
Previous Name (if applicable) ______________________________________________________________________
(b)Date of Birth: _________________________________ (c) Place of Birth: _________________________________
(d) Nationality: __________________________________ (e) Former Nationality (if any) ________________________
(f) Passport No.:_________________________________ (g) Date of Issue: _________________________________
(h) Place of Issue: ________________________________ (i) Date of Expiry: ________________________________
2. Profession/Occupation: ___________________________________________________________________________
3. (a) Business Address & Tel. No. in the U.S.A:
______________________________________________________________________________________________
(b) Residential Address & Tel. No. in the U.S.A:
______________________________________________________________________________________________
4. Proposed date of departure for Ghana: _______________________________________________________________
5. (a) Traveling by: □ Air □ Sea □ Land
(b) Is applicant in possession of return ticket? ____________________________ Ticket No.:_____________________
(c) Amount of Money Applicant is traveling with_________________________________________________________
6. Purpose of Journey: □ Business □ Tourism □ Employment □ Official □ Student □ Transit
7. Names, Addresses and Telephone Numbers of Two (2) references or place of residence in Ghana/Name(s) of Hotel: (very
important)
(i) ____________________________________________________________________________________________
______________________________________________________________________________________________
(ii) ____________________________________________________________________________________________
______________________________________________________________________________________________
8. If for employment, name and address of employer in Ghana ______________________________________________
______________________________________________________________________________________________
9. Duration of stay in Ghana: _________________________________________________________________________
10. Date of last visit to Ghana: _________________________________________________________________________
11. Applicant’s signature: _____________________________________ Date of application: _______________________
NB: PLEASE ENSURE YOU ENCLOSE YOUR PASSPORT WITH YOUR APPLICATION
click to sign
signature
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