Visa Assessment Form

Contact Details
Email Address*
Contact Number*
Personal Details (as appeared in passport)
Given Name*
Surname*
Gender*
Passport number*
Passport expire date*
Date Format: DD slash MM slash YYYY
Nationality*
Service Required
What do you need assistance with?*
Visa Requirements
Are you currently in South Africa?*
If no, please specify *PLEASE NOTE THAT YOU WILL BE REQUIRED TO SUBMIT YOUR APPLICATION THROUGH YOUR NEAREST SOUTH AFRICAN EMBASSY/VFS OFFICE*
Do you currently hold a valid visa?*
Please provide details*
What category of visa do you currently hold?*
Visa expiry date*
Date Format: MM slash DD slash YYYY
Visa Category you wish to apply for*
Please specify*
How long do you intend on staying in South Africa*
Please specify*
Do you have an immediate family member (eg spouse or child(ren)) who need to apply for new visas or who need to renew/extend current visa?*
Any additional comments*
CAPTCHA
Name
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Contact Details