Sri Lankan ETA Tourist Visa Application Form www.thetravelvisacompany.co.uk Applicant Details Contact Details Passport Number: Mobile Tel No: Nationality: Daytime Tel No: Date of Birth: Gender: DAY MONTH Male YEAR The Quadrangle, Crewe Hall, Weston Road Crewe, Cheshire, CW1 6UY T 01270 250 590 | F 01270 250 029 Address to which conÿrmation should be posted: Female Country of Birth: Postcode Passport Issue Date: Email: Passport Expiry Date: Passport Issue Authority: Title: i.e. UKPA Do any of the following apply to you? (Answer Yes or No) Please call if you need additional help on any of these questions. i.e. Mr, Mrs, Miss Surname (As shown in Passport): A Given Names (As shown in Passport): B Are you currently in Sri Lanka and possess an ETA? Yes No C Do you have a multiple entry Visa for Sri Lanka? Yes No Child Details Date of Birth: Gender: Yes No (if applicable) DAY Male MONTH YEAR Female I wish to pay by: Card No: Given Names (As shown in Passport): Relationship: Travel Information DAY Payment Details (cheques made payable to The Travel Visa Company) The Travel Visa Company will charge your account £35.00 Surname (As shown in Passport): Date of travel: Do you have a valid residence Visa for Sri Lanka? MONTH YEAR Expiry Date Valid From Security last 3 digits on the Issue No. Number back of the card Switch only I hereby authorise The Travel Visa Company to debit my Debit/Credit card for the sum of: Name of cardholder Length of stay: Purpose of visit: Signature: .................................................................................................................................................................. Flight Number: * Certiÿcation: I, the applicant, hereby certify that I have read, or have had read to me, all the questions and statements on this application and understand all the questions and statements on this application. The answers and information furnished in this application are true and correct to the best of my knowledge and belief. Port of Departure: Airline: Address whilst in Sri Lanka (if known):
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