Algeria Visa Application for Citizens of United States by dxu18403

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									                                                                                    Mail documents to: VisaHQ.com
                                                                                                       2005 Massachusetts Avenue, NW
                                                                                                       Washington, DC 20036
                                                                                                       Tel: 800-345-6541




                                      Algeria Tourist visa Application

          IMPORTANT: Please enter your contact information


Name:

E-mail:

Tel:                                                                      Mobile:

The latest date you need your passport returned in time for your travel:




          Algeria tourist visa checklist

        Filled out and signed Algeria 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.

        2 Photographs. Standard passport photographs 2 x 2 inches on white background.

        Payment. Credit Card Authorization form, Certified Check, or Money Order payable to VisaHQ.com.

        Return mailer. Prepaid self-addressed return label or payment for FedEx.




                 If you wish to prepay return shipping,                         Name:
                 please add the shipping fee to the total
                 and provide the return shipping address:                       Company:


                      FedEx 2nd day delivery - add $15                          Address:

                      FedEx Standard Overnight - add $20
                      FedEx Priority Overnight - add $25
                      FedEx Saturday delivery - add $45                         City:

                      FedEx First Overnight - add $65                           State:                         Zip:




          Itinerary. Copy of round trip tickets or confirmed itinerary.
          Hotel Reservations. Copy of confirmed hotel reservations.




                                                            VisaHQ.com, 2005 Massachusetts Avenue, NW, Washington, DC 20036, (202)558-2216
                                                                         Mail documents to: VisaHQ.com
                                                                                            2005 Massachusetts Avenue, NW
                                                                                            Washington, DC 20036
                                                                                            Tel: 800-345-6541




                Algeria tourist visa fees for citizens of United States

        Type of visa              Max. validity     Embassy fee          Our fee        Processing time            Total
           Single Entry            up to 90 days         $166.00            $129.95        20 business days        $295.95




                                  Credit Card Authorization Form
I authorize VisaHQ.com to charge my credit card for the amount of $


   Name on the Credit Card:

   Credit Card number:                         -          -             -               Exp. date:            /

   Credit Card Billing Address:




   Signature:




   Comments:




                                                     Thank you!
                                           We accept all major credit cards.




                                                   VisaHQ.com, 2005 Massachusetts Avenue, NW, Washington, DC 20036, (202)558-2216
                                                                                                                                                                                                                                                                                                         ‫اﻟﺠــﻤـﻬـﻮرﻳــﺔ اﻟﺠﺰاﺋﺮﻳــﺔ اﻟﺪﻳﻤﻘﺮاﻃﻴــﺔ اﻟﺸــﻌﺒﻴــﺔ‬
                                                                                                                         Post: WASHINGTON                                       ‫اﻟﻤﺮآﺰ: واﺵﻨﻄﻦ‬                                                                                            PEOPLE’S DEMOCRATIC REPUBLIC OF ALGERIA
                                                                                                                                                                                                           ‫ﻃـــــــــــﻠــــــﺐ ﺕــــــــــــﺄﺵــــــﻴـــﺮة‬                                                                                                             ‫ﻥﻮع اﻟﺘﺄﺵﻴﺮة‬
                                                                                                                                                                                                                                VISA APPLICATION                                                                                                                   Visa category
                                                                                                                                                                                                                                                                                                                                                                   ……………….

                                                                                                                          ‫اﻟﻠﻘﺐ‬                                                                                                ‫اﻻﺱﻢ‬
                                                                                                                         Last name ……………………………………………………. First name …………………………………………………………………………
                                                                                                                         ‫اﻻﺱﻢ ﻗﺒﻞ اﻟﺰواج‬                                                                ‫اﺱﻢ ﺁﺧﺮ‬
                                                                                                                         Maiden name ………………………………………………… Middle name ……………………………………………………………….………                                                                                                                                                                   ‫اﻟﺮﺟﺎء اﻟﺼﺎق‬
                                                                                                                         ‫ﺗﺎرﻳﺦ اﻟﻤﻴﻼد‬                                                                  ‫اﻟﻤﺪﻳﻨﺔ‬                                                       ‫اﻟﻮﻻﻳﺔ‬                                                                                          ‫اﻟﺼﻮرة هﻨﺎ‬
                                                                                                                         Date of birth .............................................. (DAY/MONTH/YEAR) City........................................................ State….................……….……....…….
                                                                                                                         ‫اﺱﻢ اﻷب‬                                                                       ‫اﺱﻢ اﻷم‬
IMPORTANT: False statements will lead to the application being rejected or to the annulment of a visa already granted.




                                                                                                                         Father’s name……………………………………………….. Mother’s maiden & first name………………….…………………………….…….                                                                                                                                                  Please you must
                                                                                                                          * ‫اﻟﻮﺽﻌﻴﺔ اﻟﻌﺎﺋﻠﻴﺔ‬                 ‫أﻋﺰب‬                          ‫ﻣﺘﺰوج‬        ‫ﻣﻄﻠﻖ‬                   ‫أرﻣﻞ‬                                 ‫اﻟﺠﻨﺲ‬            ‫ذآﺮ‬     ‫أﻥﺜﻰ‬                                                                attach photo
                                                                                                                         Marital status (*)                 Single                        Married      Divorced               Widow (er)                           Gender (*)         M      F                                                                        here
                                                                                                                         ‫اﻟﺠﻨﺴﻴﺔ اﻟﺤﺎﻟﻴﺔ‬                                                                ‫اﻟﺠﻨﺴﻴﺔ اﻷﺹﻠﻴﺔ‬
                                                                                                                         Present Citizenship………………………………………….. Citizenship at birth ……………………………………………..…………….…….
                                                                                                                         ‫اﻟﻌﻨﻮان اﻟﺸﺨﺼﻲ‬                                                                                                                 ‫رﻗﻢ هﺎﺗﻒ اﻟﺒﻴﺖ‬
                                                                                                                         Personal address……………………………………………………………………..…………...Home phone …….……...……………………….
                                                                                                                         E-mail…………………………………………………………………………………Cell phone ………………………………….                                                                                                                                                                             ‫ﺧﺎص ﺑﺎﻻدارة‬
                                                                                                                                                 (‫زوج )ة‬
                                                                                                                                                                                                                                                                                                                                                                    For office use
                                                                                                                         Husband-wife                                                                                                                                                                                                                                    only
                                                                                                                          ‫اﻟﻠﻘﺐ‬                                                     ‫اﻻﺱﻢ‬
                                                                                                                         Last name (Maiden name for wife)….………………………………………….…… First name ………….……………………………………
                                                                                                                           ‫ﺗﺎرﻳﺦ اﻟﻤﻴﻼد‬                                 ‫اﻟﻤﺪﻳﻨﺔ‬            ‫اﻟﻮﻻﻳﺔ‬
                                                                                                                         Date of birth ……………….………….. .(DAY/ MONTH/YEAR) City………………………….... State ………………………………..…..……..
                                                                                                                                                                                                                                                                                                                                                                      ‫رﻗﻢ اﻟﻄﻠﺐ‬
                                                                                                                         Children                                           ‫اﻷﻃﻔﺎل‬                  to be filled when they travel with you                                                                      ‫ﻻ ﻳﻤﻠﺊ اﻻ ﻓﻲ ﺡﺎﻟﺔ ﺱﻔﺮ اﻷوﻻد‬                     Application Number
                                                                                                                         ‫اﻻﺱﻢ و اﻟﻠﻘﺐ‬                                                                ‫ﺗﺎرﻳﺦ اﻟﻤﻴﻼد‬                        ‫ﻣﻜﺎن اﻟﻤﻴﻼد‬                                                                     ‫اﻟﺠﻨﺴﻴﺔ‬
                                                                                                                         Last & First name                                                          Date of birth            DAY/ MONTH/YEAR
                                                                                                                                                                                                                                                              Place of birth                                               Citizenship                              ‫ﺗﺎرﻳﺦ اﻻﻳﺪاع‬
                                                                                                                                                                                                                                                                                                                                                                    Received on

                                                                                                                         Type of travel document                                                              ‫ﻃﺒﻴﻌﺔ وﺙﻴﻘﺔ اﻟﺴﻔﺮ‬                                                                                                                                   ‫ﻋﺪد ﻣﺮات اﻟﺪﺧﻮل‬
                                                                                                                         ‫ﺝﻮاز ﺱﻔﺮ ﻋﺎدي‬                                                            {‫وﺙﻴﻘﺔ أﺧﺮى }ﺗﻮﺽﻴﺢ‬                                                                                                                                                  ‫اﻟﻤﺮﺧﺼﺔ‬
                                                                                                                         Ordinary passport                                                         other document             (give precision)…………………………………………………………                                                                                             Nbr. of authorized
                                                                                                                         ‫رﻗﻢ‬                                                                      ‫اﻟﺼﺎدر‬                                        ‫ﻳﻨﺘﻬﻲ ﻓﻲ‬                                                                                                               entries
                                                                                                                                                                                                                      DAY/ MONTH / YEAR                                                             DAY / MONTH / YEAR
                                                                                                                         Number......................................................... Issued on........................................................ Expire on..................................................................

                                                                                                                         {*}‫ﺗﺄﺷﻴﺮة ﻣﻄﻠﻮﺑﺔ ﻟﻠﺪﺧﻮل‬                                                ‫ﻣﺮة واﺡﺪة‬                                    ‫ﻣﺮﺗﻴﻦ‬                                 ‫ﻋﺪة ﻣﺮات‬
                                                                                                                         Visa solicit for (*)                                                    1 entry                                   2 entries                             several entries
                                                                                                                                                                                                                                                                                                                                                                      ‫ﻣﺪة اﻻﻗﺎﻣﺔ‬
                                                                                                                          ‫اﻟﻤﻬﻨﺔ‬                                ‫اﻟﻤﺴﺘﺨﺪم‬                                                                                                                                                                                         Duration of stay
                                                                                                                         Occupation……………………………………………………….. Employer ……………………………………………………………………
                                                                                                                         ‫اﻟﻌﻨﻮان اﻟﻤﻬﻨﻲ‬                                      ‫رﻗﻢ هﺎﺗﻒ اﻟﻤﻜﺘﺐ‬
                                                                                                                         Address of employer ……………………………………………………………………………………Office phone ….………………………...
                                                                                                                                                                                                                                                                                                                                                                 ‫اﻟﻀﺮﻳﺒﺔ اﻟﻤﺴﺘﺤﻘﺔ‬
                                                                                                                          ‫ﻓﻲ ﺡﺎﻟﺔ ﻋﺒﻮر‬                          ‫اﻟﻮﺝﻬﺔ اﻟﻨﻬﺎﺋﻴﺔ‬                                                                                                                                                                                       Tax
                                                                                                                         In case of transit                    final destination ……………………………………………………………………………………………
                                                                                                                         {*}‫هﻞ ﻟﺪﻳﻜﻢ ﺗﺄﺷﻴﺮة دﺧﻮل ﻟﻬﺬا اﻟﺒﻠﺪ‬                       ‫ﻥﻌﻢ‬          ‫ﻻ‬
                                                                                                                         Do you have visa for this country (*)                   Yes          No                                                                                                                                                                ‫ﺗﺎرﻳﺦ ﺹﺪور اﻟﺘﺄﺷﻴﺮة‬
                                                                                                                           ‫اﻟﻌﻨﻮان أﺙﻨﺎء اﻹﻗﺎﻣﺔ‬                                                                                                                                                                                                                      Issued on
                                                                                                                         Address during your stay…………………………………………………………………………………………………………………………………………………..
                                                                                                                          ‫ﻏﺮض اﻹﻗﺎﻣﺔ‬
                                                                                                                         Purpose         …………………………………………………………………………………………………………………………………………………………………
                                                                                                                                                                                                                                                                                                                                                                ‫اﻟﺘﺎرﻳﺦ اﻟﻤﺤﺪد ﻟﻼﺱﺘﻌﻤﺎل‬
                                                                                                                         ‫اﺱﻢ اﻟﺸﺨﺺ اﻟﻤﻘﺼﻮد ﻓﻲ اﻟﺠﺰاﺋﺮ‬                                                                                                                                                 ‫رﻗﻢ اﻟﻬﺎﺗﻒ‬
                                                                                                                                                                                                                                                                                                                                                                    Date limit of
                                                                                                                         Name of your contact in Algeria………………………………………………………………………………………………….Phone…………………………..…….
                                                                                                                          ‫ﻣﺪة اﻹﻗﺎﻣﺔ‬                                                                                                       ‫ﻣﻦ‬                                                           ‫إﻟﻰ‬                                                           utilization
                                                                                                                         Length of stay ………………………………………………………………… From ………………………………………To…………………………….………


                                                                                                                         ‫هﻞ ﺱﺒﻖ ﻟﻜﻢ زﻳﺎرة اﻟﺠﺰاﺋﺮ ؟‬                                                                                                                                                                                                                   ‫رﺋﻴﺲ اﻟﻤﺮآﺰ‬
                                                                                                                         Have you already visited Algeria? ………………………………………………………………………………………………………………….…                                                                                                                                                           (‫)اﻻﻣﻀﺎء و اﻟﺨﺘﻢ‬
                                                                                                                         ‫آﻢ ﻣﺮة زرﺗﻢ اﻟﺠﺰاﺋﺮ؟‬           ‫ﻓﻲ أي ﺗﺎرﻳﺦ ؟‬                         ‫ﻣﺪة اﻹﻗﺎﻣﺔ‬                                                                                                                                                           Chief of post
                                                                                                                         Number of visits……………. when?                ……………………………………………………….. Length of stay …....………….. ........................                                                                                                                  (Signature and
                                                                                                                                                                                                                                                                                                                                                                      stamp
                                                                                                                                                                                                                       ‫أﻟﺘﺰم ﺑﻤﻐﺎدرة اﻻﻗﻠﻴﻢ ﺑﻌﺪ اﻥﻘﻀﺎء أﺝﻞ اﻟﺘﺄﺷﻴﺮة اﻟﺘﻲ ﺱﺘﻤﻨﺢ ﻟﻲ و ﺑﻌﺪم ﻗﺒﻮل أي ﻋﻤﻞ ﻣﺄﺝﻮر أو ﻏﻴﺮ ﻣﺄﺝﻮر ﺧﻼل إﻗﺎﻣﺘﻲ، و ﺑﻌﺪم اﻹﻗﺎﻣﺔ ﺑﺼﻔﺔ ﻥﻬﺎﺋﻴﺔ‬
                                                                                                                         I undertake to leave the Algerian territory at the expiration of the visa which would be granted to me, and to refuse any employment being paid or not, during my stay, and to not establish me there
                                                                                                                                                                                                                                                              ‫هﺎم : ﺗﻤﻠﻰء ﺝﻤﻴﻊ اﻟﺨﺎﻥﺎت ﺑﺤﺮوف واﺽﺤﺔ، ﻓﻲ ﺡﺎﻟﺔ ﺧﻄﺄ أو ﻋﺪم ﻣﻠﻰء ﺑﻌﺾ اﻟﺨﺎﻥﺎت ﻟﻦ ﻳﺮد ﻋﻠﻰ ﻃﻠﺒﻜﻢ‬
                                                                                                                         IMPORTANT: All categories must be completed in CAPITAL LETTERS in case mistakes or omissions; your application will be rejected
                                                                                                                         (*) Put an X in the category corresponding to your answer                                                             ‫ ﻓﻲ اﻟﺠﻮاب اﻟﻤﺨﺘﺎر‬X ‫}*{ ﺽﻊ ﻋﻼﻣﺔ‬



                                                                                                                                                                                                                                                                                                                {‫اﻟﺘﺎرﻳﺦ، و إﻣﻀﺎء اﻟﻤﻌﻨﻲ } ﺹﺎﺡﺐ اﻟﻄﻠﺐ‬
                                                                                                                                                                                                                                                                                                    DATE AND APPLICANT SIGNATURE

                                                                                                                                                2009                                                                                                                                                                  MAE-AC-42

								
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