FEDERAL REPUBLIC OF NIGERIA
NIGERIA IMMIGRATION SERVICE
APPLICATION FORM FOR WORK/ENTRY PERMIT
Form must be completed in full, your application may be rejected for wrong and misleading information.
1. Surname (MR/MRS/MISS)……………………………………………………………………………………….
2. Sex………………………………………………Marital Status………………………………………………….
3a. Present Nationality…………………………………3b. Previous Nationality……………………………………
4a. Date of Birth (day/month/year)………………………………..4b.Place of Birth………………………………..
5. Residential Address………………………………………………………………………………………………
…………………………………………………………….Telephone No………………………………………...
6. Office Address……………………………………………………………………………………………………..
…………………………………………………………….Telephone No…………………………………………
7. Profession…………………………………………………………………………………………………………...
8. State what branches of the Armed Forces of your country you have served in or are serving
in………………………………………………………………………From……………..to……………………..
9. Colour of Hair………………………………...Colour of eyes………………...Height……………………………
10. Visible identification mars……………………………………………………………………………………….....
11. Passport No…………………….Date of issue……………………………..Date of expiry……………………….
Place issue……………………………………….issuing Government…………………………………………….
12. Purpose of journey (please give full details)………………………………………………………………………..
……………………………………………………………………………………………………………………....
13. Number of entries requires. A. Single B. Multiple
14. Intended duration of stay…………………………………………………………………………………………...
15. Proposed date of travel (day/month/year)……………………………….(15b) Mode of travel to Nigeria………..
16. Indicate how much money is available for your trip……………………………………………………………….
17. If your reason for journey to Nigeria is for employment, state:
a) Name of Employers……………………………………………………………………………………….
b) Post to be occupied………………………………………………………………………………………..
c) Give a full description of job……………………………………………………………………………...
…………………………………………………………………………………………………………….
18. Persons joining spouses, parents or relatives, should give full particulars of the employment
of parent of spouse in Nigeria including the address where they reside…………………………………………...
………………………………………………………………………………………………………………………
19. How long has/have your spouse/parents been in Nigeria…………………………………………………………..
20. Your Intended address in Nigeria (NOT P.O.Box)…………………………………………………………………
………………………………………………………………………………………………………………………
21. Have you ever applied for a Nigerian visa before? Yes/no/………………………………………………………..
22. Where did you apply for the visa? ............................................................................................................................
23. Indicate whether visa was granted or rejected……………………………………………………………………..
24. Give reason if visa was rejected…………………………………………………………………………………….
25. Have you ever visited Nigeria? Yes/No…………………………………………………………………………….
Photograph
26. If yes, was it for:
i. Tourism
ii. Business
iii. Temporary Employment
iv. Residency
v. Transit
27. State the Period of these visits and the Addresses at which you stayed……………………………………………
From To Address
i. …………………….. ……………………. …………………………………………………………….
ii. …………………….. ……………………. …………………………………………………………….
iii. …………………….. ……………………. …………………………………………………………….
28. How long have you lived in the country where you are applying for visa/entry permit?..........................................
………………………………………………………………………………………………………………………
29. Have you ever:
a) Been infected by any contagious disease (eg. Tuberculosis) or suffered serious metal illness?
Yes………………………No……………………………………………………………………………..
b) Been arrested or convinced for any offence or crime even though subject of pardon, arrested or other
such legal action? Yes…………………No………………………………………………………………
c) Been involved in narcotic activities? Yes……………………No………………………………………..
d) Been deported? Yes…………No………….if so, from which country?....................................................
e) Sought to obtain a visa by misrepresentation or fraud? Yes……………No…………………………….
f) tested positive to HIV AIDS? If yes, please state status…………………………………………………
30. Give a list of the countries you have lived in for more than a year during the last five years:
Country city Date
…………………………. ………………………… …………………………..
…………………………. ………………………… …………………………..
…………………………. ………………………… …………………………..
…………………………. ………………………… …………………………..
…………………………. ………………………… …………………………..
31. Which countries have you visited during the last twelve (12) months:
Country city Date
…………………………. ………………………… …………………………..
………………………….………………………… …………………………..
…………………………. ………………………… …………………………..
…………………………. ………………………… …………………………..
…………………………. ………………………… …………………………..
I understand that I will be required to comply with the Immigration/Alien and other laws governing entry of
Immigrants unto the country for which I now apply for work visa/Entry Permit.
Date…………………………………Signature………………………………………….
For official use only.
DATE REMARKS (FOR OFFICIAL USE ONLY)
Note: Application Fee of $750 is payable in advance in USD in CASH (if the application is made by the
applicant in person), Western Union Money Transfer/Money Gram payments are accepted if the applicant
is not making the application in person. Personal cheque's, Bank Drafts will NOT be accepted.
*Applicant’s passport, visa and any original documents, will be sent by post using recorded delivery.
Receipts will be issued upon payment.
ALL APPLICATIONS AND SUPPORTING DOCUMENTS MUST BE IN ENGLISH
The application form MUST be FULLY completed, signed and dated, then submitted with the following:
Your Passport
One recent passport-sized photograph.
Purpose for Trip:
Educational - Letter of Introduction from the University or Educational Institution.
Business/Work - Letter of Introduction from company or Organization and supporting documents
$750 Visa Application fee payable in advance in USD in CASH (if the application is made by the
applicant in person), Western Union Money Transfer/Money Gram payments are accepted if the applicant
is not making the application in person.
