1 TOURIST VISA REQUIREMENTS GHANA (Multiple Entry), TOGO and BENIN Total cost One person 5 $538 Total cost Two people $1058 Cost includes, consular fees* and return shipping For delivery outside the contiguous U.S. please add additional $ For FedEx Overnight Delivery please add $10.00 to above costs. Please Send to GENERATIONS VISA SERVICE: (see address below) Your signed passport: having four completely blank visa pages & six months validity beyond the travel date. For help with passport processing, including adding visa pages, call GenVisa at Six (6) recent passport photos per person (approx 2x2) no home photos / no photocopies. Two completed and signed visa application forms per person for Togo and Ghana and one for Benin (attached). Three (3) copies of International Certificate of Vaccination for Yellow Fever is required. Three (3) copies of your flight itinerary provided by Road Scholar Travel Services. If you are traveling as a program only participant and making your own flight arrangements, please submit an international travel I itinerary on airline, website or travel agency letterhead. Payment: a check or money order payable to GenVisa in US Dollars and drawn on a US bank. Complete and return this entire form with the requested materials use a traceable form of mail. Important: Do not send your passport/materials more than 3 months prior to your program departure date. If you need your passport returned within 45 days: add $125 per person for expedited service. If you are departing within 30 days: add $305 per person for expedited service, within 14 days: call GenVisa prior to sending your materials.*consular fees and forms are subject to change without notice. For terms and conditions, current requirements, updated forms and fees please go to YOUR RETURN ADDRESS Last Name: First Name: Last Name: First Name: Return to: Home or Business (recommended for security reasons) Name & c/o: EXACT address: Apt/Ste#: Phone: City: State: Zip Code: Date you need your passport: Your address (Important): Date THIS PROGRAM Departs US: Program/Booking # (Important) Optional insurance: $8.00 per passport: in the unlikely event that your passport is lost or damaged in transit. This will cover your full out of pocket visa(s) and passport replacement costs up to $2,000. Please check one of the boxes below. Yes, I have added an additional $8.00 per person for the optional insurance. [FedEx signature required upon delivery.] No, I decline the optional insurance and understand that in the unlikely event my passport is lost or damaged, Generations Visa Service liability is limited to $100. [No signature required upon delivery.] Send materials to: GENERATIONS VISA SERVICE 2233 WISCONSIN AVE N.W. #226 WASHINGTON D.C Road Scholar Ghana/Togo/Benin
2 For Official Use Visa No.: Type of Visa: Date of Issue: Charges: Issuing Officer: Please check applicable box Single Entry - $60.00 Multiple Entries - $ Single Entry (Rush) - $ Multiple Entries (Rush) $ (Pay by money order. Personal checks are not accepted) Affix passport Picture here Application for Ghana Entry Permit/Visa Embassy of Ghana, 3512 International Drive NW - Washington DC Website: Tel: (202) INSTRUCTIONS: 1. This form must be completed in duplicate and in capital letters and submitted (together with two(2) recent passportsize pictures) at least Fourteen (14) days before the intended date of departure. 2. Full names and addresses of references/hotel (place of stay) in Ghana should be stated (including telephone numbers, if available). 3. Any information stated on the form and subsequently found to be incorrect may render entry permit/visa void. 4. Applicants applying by post/mail should provide trackable return self-addressed envelopes. 1. (a) Surname: First Name (s): Previous Name (if applicable) (b)date of Birth: (c) Place of Birth: (d) Nationality: (e) Former Nationality (if any) (f) Passport No.: (g) Date of Issue: (h) Place of Issue: (i) Date of Expiry: 2. Profession/Occupation: 3. (a) Business Address & Tel. No. in the U.S.A: (b) Residential Address & Tel. No. in the U.S.A: 4. Proposed date of departure for Ghana: 5. (a) Traveling by: Air Sea Land (b) Is applicant in possession of return ticket? Ticket No.: (c) Amount of Money Applicant is traveling with 6. Purpose of Journey: Business Tourism Employment Official Student Transit 7. Names, Addresses and Telephone Numbers of Two (2) references or place of residence in Ghana/Name(s) of Hotel: (very important) (i) (ii) 8. If for employment, name and address of employer in Ghana 9. Duration of stay in Ghana: 10. Date of last visit to Ghana: 11. Applicant s signature: Date of application: NB: PLEASE ENSURE YOU ENCLOSE YOUR PASSPORT WITH YOUR APPLICATION
3 EMBASSY OF THE REPUBLIC OF TOGO 2208 Massachusetts Avenue, NW, Washington DC 2008 Phone: Fax: attach photo LIBERTE For Official Use: Visa #: Type of Visa: Date of Issue: Charges: Signature of Issuing officer: RT APPLICATION FOR REPUBLIC OF TOGO ENTRY PERMIT / VISA 1.(a) Applicant Surname: Applicant First names: Previous names (if applicable): b. Date of Birth: c. Place of Birth: d. Nationality / Current Citizenship: e. Former Nationality (if any) f. Other citizenships held/ previous citizenships: g. Passport date of issue: h. Passport Place of issue: i. Passport Number: j. Passport date of expiration: 2. Current Profession or Occupation: 3(a). Business address / phone / fax / e mail: 3(b). Residential address / phone / fax / e mail: 4. Proposed date of Departure: 5. Traveling by: Air Sea Land Is applicant in possession of a return ticket? Ticket issuer & number: 6. Purpose of journey: Business Tourism Employment Official 7. Names and addresses of two references: (i) (ii) 8. If for employment, name and address of employer: 9. Duration of stay: 10. Date of last visit: 11. Applicant signature: Date:
4 REPUBLIQUE DU BENIN AMBASSADE DU BENIN AUX ETATS-UNIS D AMERIQUE EMBASSY OF THE REPUBLIC OF BENIN 2124 Kalorama Road N.W. Washington, D.C DEMANDE DE VISA APPLICATION FOR VISA -:-:-:-:-:-:-:-:-:- RESERVE AU CONSULAT REFERENCE : TAXES PERCUES : MODE DE PAIEMENT : Nom (en capitales) Surname (in capitals) Née : (Nom de jeune fille Maden Name) Prénoms : First names (in small letters) Né le à Born on at D origine : Nationalité at birth Nationality actuelle : present Situation de famille : Enfants : Nombre Ages Married or single Number of children Ages Résidence (adresses exacte) Present address in full Téléphone Phone Profession: _ Occupation PHOTOGRAPH Passport N Délivrée le issued on Par : By Valable jusqu au Valid until Situation militaire : Military service status Nature et durée du visa sollicité : Transit à destination de : Transit en route to Avec arrêt de : jours With a stay of (Le cadre ci-contre doit être rempli par le: SEJOUR DE : jours demandeur qui rayera les mentions inutiles) STAY OF days Type and validity of visa requested : (The space opposite should be filled in) mois months ( ) unique ( ) multiple Motifs du voyage : Reason for journey Avez-vous déjà résidé en République du Bénin pendant plus de trois mois sans interruption? Have you already resided in the Republic of Benin for more than three months continuously? Précisez à quelle date: When (give exact date) : Attaches familiales en République du Bénin (adresses exactes ) rue et n Have you any relations in the Republic of Benin (give full addresses, including street and street number
5 2 Références dans le pays de résidence (adresse) : Reference in the country of residence (give full address) Indication précise du lieu d entrée en République du Bénin : State exact point of entry into the Republic of Benin Indication de vos addresses exactes en République du Bénin pendant que vous y séjournerez State your full address, during your stay in the Republic of Benin Comptez-vous installer en République du Bénin un Commerce ou une Industrie? Do you intend to establish a business or a factory in the Republic of Benin? Où comptez-vous vous rendre en sortant de la République du Bénin? Where do you intend to go upon your departure from the Republic of Benin? Je déclare avoir donné des réponses exactes et complètes à toutes les questions de la présente demande. I declare that I have answered all required questions in this application fully and truthfully. Signature du requérant Signature of Applicant Date
6 Smart Traveler Enrollment Program Stay Informed, Stay Connected, Stay Safe! For a nominal fee GenVisa will register you and your travel details with the nearest U.S. Embassy or Consulate in the countries you are visiting. This key feature allows the US government to efficiently safeguard its citizens while overseas. Benefits of Enrolling in Smart Traveler Enrollment Program Receive important information from the Embassy about up-to-the-minute safety conditions in your destination country, helping you make informed decisions about your travel plans. Help the U.S. Embassy contact you in an emergency, whether natural disaster, civil unrest, or family emergency. Help family and friends get in touch with you in the case of an emergency. Traveler #1: Full name (LAST, First, Middle): Personal Information Traveler #2: Full name (LAST, First, Middle): Date of Birth (MM/DD/YYYY): / / Passport Number: Date of Issue (MM/DD/YYYY): / / Expiration Date (MM/DD/YYYY): / / Home Address: Date of Birth (MM/DD/YYYY): / / Passport Number: Date of Issue (MM/DD/YYYY): / / Expiration Date (MM/DD/YYYY): / / Home Address: Address*: Phone Number: * addresses will not be used for solicitation purposes Address*: Phone Number: Travel Information Country #1: Approx. Date of Entry (MM/DD/YYYY): / / Approx. Date of Exit (MM/DD/YYYY): / / Name and Address of the first hotel: Country 2 (if applicable): Approx. Date of Entry (MM/DD/YYYY): / / Approx. Date of Exit (MM/DD/YYYY): / / Name and Address of the first hotel: Contact in Country (phone or ): Contact in Country (phone or ): Yes, please enroll me in Smart Traveler Program. I have added an additional $12.50 per person for this service. No, I decline the optional Smart Traveler Program enrollment service. Please note: An confirmation will be sent to your on record and you must confirm using the link in the within 48 hours.