UKRAINE. GLUKHOV IGOR, UKRAINE. GLUKHOVA SVITLANA, UKRAINE. TRAVEL DOCUMENT OF A CHILD. Ap. 33, B. 43-A, Tyraspilska Str., Kyiv. Student of the school. .Secondary school № 63,. 10-a, M. Grechka Str., Kyiv, 04136, tel 424-82-49. HUNGARY. c/vallderoure,17,

Application for Schengen Visa

This application form is free

1. Surname (Family name) (x)

                                       GLUKHOVA

FOR OFFICIAL USE ONLY

Date of application:

Visa application number: Application lodged at

□ Embassy/consulate

□ CAC

□ Service provider

□ Commercial intermediary

□ Border

Name:

□ Other

File handled by:

Supporting documents:

□ Travel document

□ Means of subsistence

□ Invitation

□ Means of transport

□ TMI

□ Other:

Visa decision:

□ Refused

□ Issued:

□ A

□ C

□ VTL

□ Valid: From Until

Number of entries:

□ 1 □ 2 □ Multiple

Number of days:

2. Surname at birth (Former family name(s)) (x)

                                       GLUKHOVA

3. First name(s) (Given name(s)) (x)

                                       POLINA

4. Date of birth (day-month-year)

05. 07. 2001

5. Place of birth

KYIV

6. Country of birth

UKRAINE

7. Current nationality

UKR

Nationality at birth, if different:

UKR

8. Sex

□ Male     v  Female

9. Marital status

v Single □ Married □ Separated □ Divorced □ Widow(er)

□ Other (please specify)

10. In the case of minors: Surname, first name, address (if different from applicant's) and nationality of parental

authority/legal guardian

GLUKHOV IGOR, UKRAINE

GLUKHOVA SVITLANA, UKRAINE

11. National identity number, where applicable

12. Type of travel document

□ Ordinary passport □ Diplomatic passport □ Service passport □ Official passport □ Special passport

□ Other travel document (please specify)

TRAVEL DOCUMENT OF A CHILD

13. Number of travel document

AO821145

14. Date of issue

08 OCT 12

15. Valid until

08 OCT 15

17. Applicant's home address and e-mail address

Ap. 33, B. 43-A, Tyraspilska Str., Kyiv

Telephone number(s)

044-400-06-64

38 066-785-75-88

18. Residence in a country other than the country of current nationality

□ No

□ Yes. Residence permit or equivalent ………………… No. …………………….. Valid until

* 19. Current occupation

Student of the school

* 20. Employer and employer's address and telephone number. For students, name and address of educational establishment

. Secondary school № 63,

10-a, M. Grechka Str., Kyiv, 04136, tel 424-82-49

I am aware that once the visa request has been submitted, a copy of the form, sealed with the indication of the date and place of reception, shall be returned to the applicant and that arrangements can be made with the applicant as to the channel to request corrections or the supply of documents or certificates, as well as to serve notice of summons and to notify the decision adopted in due course.

Notices and requests shall be served by telephone or fax to the contact number provided by the interested party or his/her legal representative. If they were to prove ineffective, they shall be served in writing to the domicile set out in the application, which must be located within the consular district.

Summons and requests served must be complied with within a period not exceeding ten days, unless personal attendance is required in which case the deadline is fifteen days.

Once all the possibilities of serving a notice have been exhausted, the notice shall be served by means of an announcement posted at the relevant notice board of the Embassy or Consulate during ten days.

If no reply is received to a request or summons, the applicant shall be deemed to have withdrawn his request and the resolution establishing this to be the case shall be notified to him.

Applications shall be decided on within 15 calendar days of the date of the lodging of an application. That period may be extended up to a maximum of

30 calendar days in individual cases, notably when further scrutiny of the application is needed or in cases of representation where the authorities of the represented Member State are consulted. Exceptionally, when additional documentation is needed in specific cases, the period may be extended up to a maximum of 60 calendar days.

The visa once granted must be collected within a month. If a visa is not collected within the aforesaid period, the applicant shall be deemed to have renounced to the visa granted and the proceedings shall be filed.

21. Main purpose(s) of the journey:

□ Tourism □ Business □ Visiting family or friends V Cultural □ Sports □ Official visit

□ Medical reasons

□ Study □ Transit □ Airport transit □ Other (please specify)

23. Member State of first entry

HUNGARY

25. Duration of the intended stay or transit

Indicate number of days

17 DAYS

26. Schengen visas issued during the past three years

□ No

V Yes. Date(s) of validity from …………………. to ………………..

                                    18. 06. 13 – 03. 07. 13 Spain

27. Fingerprints collected previously for the purpose of applying for a Schengen visa

v No

□ Yes. Date, if known:

28. Entry permit for the final country of destination, where applicable

Issued by ……………………………….. Valid from …………………………until…………………

30. Intended date of departure from the Schengen area

03. 07. 13

* 31. Surname and first name of the inviting person(s) in the Member State(s). If not applicable, name of hotel(s) or

temporary accommodation(s) in the Member State(s)

Address and e-mail address of inviting person(s)/hotel(s)/temporary

accommodation(s)

Hotel “Bon Repos” 3 *

c/vallderoure, 17, 08370 Calella

*32. Name and address of inviting company/organization

FESTIVAL INTERNACIONAL DE FOLKLORE   

                      “ALEGRIA”

Surname, first name, address, telephone, telefax, and e-mail address of contact person in company/organization

FORTUNI VIATGES, C/TAMARIT 120, LOCAL 08015 BARCELONA

*33. Cost of travelling and living during the applicant's stay is covered

V by the applicant himself/herself

Means of support

V Cash

□ Traveller's cheques

□ Credit card

V Pre-paid accommodation

V Pre-paid transport Medical insurance

□ by a sponsor (host, company, organisation), please specify

□ referred to in field 31 or 32

□ other (please specify) Means of support

□ Cash

□ Accommodation provided

□ All expenses covered during the stay

□ Pre-paid transport

□ Other (please specify)

34. Personal data of the family member who is an EU, EEA or CH citizen

Surname

Nationality

35. Family relationship with an EU, EEA or CH citizen

□ spouse …………….. □ child ……□ grandchild ………………□ dependent ascendant

36. Place and date

Kyiv,

37. Signature (for minors, signature of parental

authority/legal guardian)

I am aware that the visa fee is not refunded if the visa is refused.

Applicable in case a multiple-entry visa is applied for (cf. field no 24):

I am aware of the need to have an adequate travel medical insurance for my first stay and any subsequent visits to the territory of Member States.

© helpiks.su При использовании или копировании материалов прямая ссылка на сайт обязательна.