NEPALESE VISA APPLICATION FORM

(For Tourist, Official and Diplomatic)

Honorary Consulate of Nepal

The Pearl Manila Hotel Bldg.
8/F 1155 General Luna St.,
Ermita, Manila 1000, Philippines
Tel. No.: (+632) 523-4684

The Ambassador / Consul General / Consul,

As I have to visit / would like to visit Nepal, I request for the issuance of Tourist Entry Visa.

1.FULLNAME 1A. Gender

[ x ]M [ ]F [ ]Other
John Marlo Merelos Evangelista
2.NATIONALITY 3. PLACE OF BIRTH 4. DATE OF BIRTH
Filipino Philippines 11 FEB 1995
Affix
recent photo 5. PERMANENT ADDRESS
Palmera Phase 4B Block 10 Lot 14, SJDM, Bulacan, Philippines
6. TEMPORARY ADDRESS IN NEPAL
Hotel Crown Imperial, Kathmandu
7. OCCUPATION
Research Staff
8. PASSPORT NUMBER 8A. DATE & PLACE OF ISSUE 8B. DATE OF EXPIRY
P0062981B DFA NCR North - 28 DEC 2018 27 DEC 2028
9. PURPOSE OF VISIT 9A. EXPECTED DATE OF ARRIVAL IN NEPAL 10. DURATION OF STAY
Attend the Second Train the Trainer Workshop on
Facilitating Distance Learning Using Digital Conferencing
Facility
30 NOV 2019 6 DAYS, 30 NOV 2019 to 6 DEC 2019

11. Number of Previous visits 12. Source of expenditure while staying in Nepal (please check one):
Zero [ ] Self [ x ] Sponsor
13. Year, month and duration of last visit:
N/A
14. Are you holding a passport of any other country? If yes, please mention
[ ] Yes [ x ] No 14a. Passport Number 14b. Country

Please check one of the following:

□ USD 30.00 for 15 days □ USD 48.00 for 30 days

___________________________ 18 NOV 2019

___________________________
Signature of Applicant Date

For official use only

1. Type of Visa: 2. Reason for Gratis, if any:

3. Entry Visa number: 4. Date of Issue:

5. Date of Expiry: 6. Visa Sticker Number:

______________________________
Issuing Officer