Volunteer Visa Instructions Cameroon
General Information On page five of this document you will find a blank visa application, please complete all fields as indicated in the instructions. If a field is not listed you should leave it blank. If you make a mistake on your visa application, please fill out a new one. The embassy will not accept visa applications that contain information which has been whited out or crossed out. Please type your responses. Any entries colored blue have been prefilled for you on the fillable visa application form. If you have any questions on completing this application please contact your Country Desk Officer:
[email protected] Put your CAPS LOCK on, all fields must be entered in ALL CAPS
Application Instructions – Section 1 □ Surname: Input your full last name(s) as it appears on your passport □ Given Name(s): Input your full first name(s) as it appears on your passport □ Maiden Name: Input your former name prior to marriage (Females only, leave blank if none) □ Date of Birth: Input your date of birth (e.g. 07-JAN-1986). □ Place of Birth: Input your city, state, and country of birth □ Citizenship – Origin: Enter the country you were a citizen of at birth, if U.S. input U.S. Citizen (This is prefilled but can be changed) □ Citizenship – Current: U.S. Citizen □ Date of Naturalization: Input naturalization date if applicable (e.g. 07-JAN1986).
Application Instructions – Section 2 □ Parents’ Names: Input your parent’s names as appropriate □ Marital Status: Select the appropriate checkbox □ Spouse’s Name/Sex/Phone: Input your spouse/partner’s information as appropriate □ Children – Number: Answer appropriately or input “N/A”
Application Instructions – Section 3 □ Passport Information: Leave Blank Travel and Transportation • Volunteer Visas – Cameroon • Updated 2018.07.01
Application Instructions – Section 4 □ Profession: Peace Corps Volunteer □ Employer: United States Peace Corps □ Military Status: N/A
Application Instructions – Section 5 □ Home Address: Input your current home address □ Contact Information: Input your current phone number and email address □ Emergency Contact: Enter the name, phone number, and relationship for your preferred emergency contact
Application Instructions – Section 6 □ Reason(s) for Traveling: Other – I will be a Peace Corps Volunteer in Cameroon □ Length of Stay: Other – 27 Months □ Number of Entries: Multiple
Application Instructions – Section 7 □ □ □ □ □ □ □ □
Place of Departure: New York, NY Date of Departure: Input the Date of Departure listed in your instructions email Transiting Through: Leave blank Place of Entry: Yaoundé Date of Entry: Input the Date of Arrival listed in your instructions email Entry By: Air Place of Departure: Yaoundé Date of Departure: Input the date that is 27 months after the Date of Arrival listed on your instructions email □ Departure By: Air
Application Instructions – Section 8 □ References in Cameroon: Danielle Monty-Mara, Peace Corps Country Director, B.P. 215, Yaoundé, Cameroon □ Address During Stay: B.P. 215, Yaoundé, Cameroon o Email:
[email protected] □ Relatives: Answer appropriately (write N/A if not applicable)
Application Instructions – Section 9 □ Ever Visited Cameroon?: Answer appropriately or input “N/A” Travel and Transportation • Volunteer Visas – Cameroon • Updated 2018.07.01
□ Uninterrupted Stay?: Answer appropriately if applicable, otherwise input “N/A” (This is prefilled but can be changed) □ Name of Manufacturers: N/A □ Establishing Business?: No
Application Instructions – Section 10 □ Agree Not to Accept Employment?: Yes
Application Instructions – Section 11 □ Signature: SIGN AND DATE APPLICATION! Make sure that no blanks are left unmarked (unless noted above). If something does not apply to you, simply write “N/A”
Travel and Transportation • Volunteer Visas – Cameroon • Updated 2018.07.01
Photo Requirements □ □ □ □ □
You will need four 2”x2” photos, this size is the same as your passport photos Photos must be printed on glossy photo paper For more guidelines and examples please visit the Department of State Website Write your full name and country on the back of all photos Place your photos in a small envelope with your name and country of service written on the front
Mailing Instructions □ Print two copies of your visa application single sided □ Verify that all of the information is correct, if any of the information is incorrect please correct and reprint, do not cross out information or use whiteout □ SIGN AND DATE BOTH APPLICATIONS! o Your name must be legible from your signature □ Mail both signed applications and photos to the address below o Do not attach the photos, instead place them in a separate envelope with your name and country of service written on the front Melwood Warehouse 5606 Dower House RD CTC Building—BSC/Peace Corps Upper Marlboro MD 20772
Travel and Transportation • Volunteer Visas – Cameroon • Updated 2018.07.01
EMBASSY OF THE REPUBLIC OF CAMEROON
AMBASSADE DE LA REPUBLIQUE DU CAMEROUN
Tél. : (202) 265-8790 Fax : (202) 387-3826 Email:
[email protected]
3400 International Drive, N.W. Washington, DC 20008 www.cameroonembassyusa.org
VISA APPLICATION / DEMANDE DE VISA (WRITE IN CAPITAL LETTERS ONLY / ECRIRE EN LETTRES MAJUSCULES SEULEMENT) 1.
TRAVELER’S IDENTITY / IDENTITE DU VOYAGEUR Surname: Nom de Famille Maiden Name (*): Nom de Jeune Fille Place of Birth: Lieu de Naissance
City: Ville
Citizenship: Nationalité
Origin: U.S. Origine
Given Name(s): Prénom(s) Date of Birth: Date de Naissance
Day/Jour Month/Mois Year/Année
State: Etat
Country: Pays
Citizen
/
Current: U.S. Actuelle
Photograph
/
(Staple or glue the photo)
2 inches X 2 inches
Citizen
Photographie (Agrafer ou coller la photo)
Date of Naturalization (*): / / Date de Naturalisation Day/Jour Month/Mois Year/Année
(*) If Applicable Si cela s’applique
Father: Père
Mother: Mère
2. Parents’ Names : Noms des Parents
Marital Status: Situation Matrimoniale
Single/Célibataire Married(a)/Marié(e) Divorced/Divorcé(e) Unmarried but Living with a Partner(a)/Pas Marié(e) mais Vivant en Couple
Widow(er)/Veuf(ve)
(a)
Spouse’s or partner’s name, sex and phone number: Nom, sexe et numéro de téléphone de l’époux(se) ou du(de la) partenaire Children: Enfants
Number: Nombre
Age Range: Tranche d’Age
3.
0–5
5 – 10
10 – 15
Over 15 / Plus de 15
TRAVELER’S PASSPORT / PASSEPORT DU VOYAGEUR Passport N°: Nº de Passeport Date of Issue: Date de Délivrance
4. Profession: Profession
Peace Corps Volunteer
5. Traveler’s Home Address In the United States: Adresse du Domicile du Voyageur aux Etats-Unis : Contact Information: Contact Emergency Contact: Contact en Cas d’Urgence
6.
Street Address Rue City: Ville Phone #: ( Nº de téléphone Name Nom
Issuing Country or Authority: Pays ou Autorité Emettrice Place of Issue: Lieu de Délivrance
Date of Expiration: Date d’Expiration
Employer: United Employeur
Military Status: N/A Situation Militaire
States Peace Corps
Apt. Nº: Nº d’Apt State: Etat E-mail:
)
Zip Code Code Zip
Phone #. ( ) Nº de Téléphone
Country: Pays
Relationship Lien / Relation
TYPE AND DURATION OF VISA REQUESTED / NATURE ET DUREE DU VISA SOLLICITE Reason(s) for Traveling: Motif(s) du Voyage Length of stay: Durée du séjour Number of Entries: Nombre d’entrées
Tourism/Tourisme Official/Officiel
Business/Affaires Transit/Transit
Days Jours Single/Unique
1 Month 1 mois ✔
✔
Studies/Etudes Family/Famille Visit/Visite Other/Autre: I will be a Peace Corps Volunteer in Cameroon 3 Months 3 Mois
6 Months 6 Mois
✔
Other: 27 Autre
Months
Multiple/Multiple RESERVED TO THE CONSULAR SERVICE / RESERVE AU SERVICE CONSULAIRE
DATE
VISA N° 1/2
7.
TRAVEL PLANS / PLANS DE VOYAGE Place of departure (City/State/Country): New York, NY
Date of departure (DD/MM/YYYY): Date de départ (JJ/MM/AAAA)
Lieu de départ (Ville/Etat/Pays)
Transiting through (List airports, cities and countries, and transit dates) / Transitant par (Citer les aéroports, villes et pays, et les dates de transit)
Place of entry in Cameroon: Yaoundé Lieu d’entrée au Cameroun Place of departure from Cameroon:
Yaoundé
Lieu de départ du Cameroun
8.
Date of entry (DD/MM/YYYY): Date d’entrée (JJ/MM/AAAA)
By Par voie
✔
Date of departure (DD/MM/YYYY): Date de départ (JJ/MM/AAAA)
By Par voie
✔
Air
Land
Sea
Aérienne
Terrestre
Maritime
Air
Land
Sea
Aérienne
Terrestre
Maritime
REFERENCES IN CAMEROON AND ADDRESS DURING YOUR STAY / REFERENCES AU CAMEROUN ET ADRESSE PENDANT VOTRE SEJOUR Notes:
(1) When indicating the addresses/destinations: specify the quarter/village/area, the city and region, any landmark near the location. (2) In case of multiple references/relatives or addresses/destinations during your stay in Cameroon: type the additional information on a separate letter-size sheet of paper titled “Section 8 – Addendum: Additional References/Relatives” or “Section 8: Addendum: Additional Addresses/Destinations”.
Notes:
(1) Lorsque vous spécifiez les adresses/destinations: précisez le quartier, la zone ou le village, la ville et la région, tout point de repère reconnu à proximité. (2) En cas de références/attaches familiales ou bien adresses/destinations multiples pendant votre séjour au Cameroun: saisir les informations additionnelles sur une feuille de papier de format lettre et inscrire comme titre « Section 8 – Addendum : Références/Attaches Familiales Additionnelles » ou bien « Section 8 – Addendum : Adresses/Destinations Additionnelles ».
References in Cameroon: References in Cameroon
Name of individual and/or organization: Danielle Monty-Mara Nom de l’individu et/ou de l’organisation Address: B.P. 215, Yaoundé, Cameroon Adresse Peace Corps Country Director Phone #: ( ) E-mail:
[email protected] Relationship: Nº de Téléphone Lien / Relation
Address/destination during your stay in Cameroon : Adresse/destination pendant Votre séjour au Cameroun
Care of: Name of Individual / Organization / Hotel: Danielle Monty-Mara Sous-couvert Nom de l’individu / l’Organisation / l’Hôtel Address: B.P. 215, Yaoundé, Cameroon Adresse Phone #: ( ) E-mail:
[email protected] Relationship: Nº de Téléphone Lien / Relation
Relatives in Cameroon: Attaches familiales au Cameroun
Name Nom Address: Adresse
✔
Phone #. ( ) Nº de Téléphone
Relationship Lien de parenté
9. Have you ever visited Cameroon? If yes, When? Avez-vous déjà visité le Cameroun? Si oui, A quelle(s) date(s)? Have you ever made an uninterrupted stay of more than three (03) months in Cameroon? Avez-vous déjà habité le Cameroun pendant plus de trois (03) mois sans interruption ? (b) Specify the dates / Précisez à quelles dates: N/A
YES/OUI(b)
NO/NON
Give names and addresses of businessmen/manufacturers you wish to meet if this is a business trip Indiquez les noms et adresses des commerçants/industriels que vous désirez rencontrer s’il s’agit d’un voyage d’affaires: N/A Do you intend to establish a business in Cameroon? Comptez-vous installer au Cameroun un commerce ou une industrie ? (c) Please specify/explain : N/A
YES/OUI(c)
✔
NO/NON
Veuillez Spécifier/Expliquer
10. Do you agree not to accept any employment, either at a salary or for room and board during your stay in Cameroon, not to seek to remain in Cameroon permanently and to leave the Cameroonian territory at the expiration of the visa that may be granted to you? Vous engagez-vous à n’accepter aucun emploi rémunéré ou au pair durant votre séjour au Cameroun, à ne pas chercher à vous y installer définitivement et ✔ YES/OUI à quitter le territoire à l’expiration du visa qui vous sera éventuellement accordé? NO/NON
11. ▪
▪
My signature engages my responsibility and exposes me, in case of false statements, and in addition to any penalties imposed by law, to be denied any Cameroonian visa in the future. Ma signature engage ma responsabilité et m’expose, en sus de poursuites prévues par la loi en cas de fausse déclaration, à me voir refuser tout visa camerounais à l’avenir. A form that is not properly filled-out will not be considered and is subject to rejection. Un formulaire indûment rempli ne sera pas pris en considération et fera l’objet d’un renvoi.
Signature (Must be that of the applicant, or legal guardian if the applicant is a minor) (Doit être celle du demandeur, ou du tuteur légal si le demandeur est mineur)
Date
2/2
