Information for Nigeria Online visa application
Personal Information
Last Name (Surname)*
(Please avoid placing suffixes with your surname)
First Name*
Middle Name
Gender*
-- Please Select --
Email*
[email protected]
Date of Birth (dd-mm-yyyy)*
/
Place of Birth*
Present Nationality*
-- Please Select --
Previous Nationality
-- Please Select --
Color of Hair*
-- Please Select --
Color of Eyes*
-- Please Select --
Identification Marks*
Height (in cm)*
/
Permanent Address
Address 1*
Address 2
City*
Country*
-- Please Select --
State*
Postcode
Permanent Phone*
+6132326565
Profession*
Office Address
Click here if you want to treat permanent address as the official address.
Address 1*
Address 2
City*
Country*
-- Please Select --
State*
Postcode
Office Phone
If you have served in the military,please state
In
From Date (dd-mm-yyyy)
/
/
To Date (dd-mm-yyyy)
/
/
Passport Information
Visa Processing Information
Issuing Country*
-- Please Select --
Passport Number*
Date of Issue (dd-mm-yyyy)*
/
/
Expiry Date (dd-mm-yyyy)*
/
Place of Issue*
/
Type of Visa Required*

Business

Transit

Tourist/Visitor

Official

Temporary Employment

STR (Subject To Regularization)
Country Applying From*
Canada
While in Nigeria, do you intend working in a licenced Free Zone Enterprise/Company?*
No
If Yes, Choose your target free zone Authority*
-- Please Select --
Visa Processing Information
Embassy of Preference (Where applicable)*
-- Please Select --
Purpose of Journey*
Number of entries required*

Single

Multiple
No. of Entries*
How much money do you have for this trip (USD)*
(Eg: 100)
Intended Duration of Stay (in days)*
Proposed date of travel(dd-mm-yyyy)*
/
/
Mode of travel to Nigeria
If the purpose of your journey to Nigeria is for employment
Name of Employer
Position to be occupied
Full description of job
Give particulars of the employment of parents,
spouse in Nigeria(if applicable)
Employer's Address
Name of Employer
Phone number of Employer
How long have your parents/spouse been in Nigeria (in months)
Address 1
Address 2
City
Country
-- Please Select --
State
Postcode
Intended address in Nigeria
Address 1*
Address 2
City*
Country *
Nigeria
State*
-- Please Select --
LGA
-- Please Select --
District
Postcode
Previous Application Information
Have you ever applied for Nigerian Visa?
No
If Yes, where did you apply for the Visa?
Was the Visa Granted or Rejected?
Granted
If Rejected, please provide reason
Have you ever visited Nigeria?
No
If Yes, for what reason
-- Please Select --
State the period of previous visits to Nigeria and address at
which you stayed
Period 1
Address
From(dd-mm-yyyy)
/
To(dd-mm-yyyy)
/
Address 1
Address 2
City
/
/
Country
Nigeria
State
-- Please Select --
LGA
-- Please Select --
District
Postcode
Period 2
Address
From(dd-mm-yyyy)
/
To(dd-mm-yyyy)
/
Address 1
Address 2
City
Country
Nigeria
State
-- Please Select --
LGA
-- Please Select --
District
Postcode
Period 3
/
/
Address
From(dd-mm-yyyy)
/
To(dd-mm-yyyy)
/
/
/
Address 1
Address 2
City
Country
Nigeria
State
-- Please Select --
LGA
-- Please Select --
District
Postcode
Travel History
How long have you lived in the country from where you are applying for visa (in Years)?*
Have you ever been infected by any contagious disease (e.g. Tuberculosis) or suffered serious
mental illness?*
No
Have you ever been arrested or convicted for an offence (even though subject to pardon)?*
No
Have you ever been involved in narcotic activity?*
No
Have you ever been deported?*
No
If you have ever been deported from which country?*
-- Please Select --
Have you sought to obtain
visa by mis-representation or fraud?*
No
Give a list of the countries you have lived for more than one
year
Period 1
Country
-- Please Select --
City
Date of departure(dd-mm-yyyy)
/
/
Period 2
Country
-- Please Select --
City
Date of departure(dd-mm-yyyy)
/
/
Period 3
Country
-- Please Select --
City
Date of departure(dd-mm-yyyy)
/
/
Give a list of the countries you have visited in the last
twelve(12) months
Period 1
Country
-- Please Select --
City
Date of departure(dd-mm-yyyy)
/
/
Period 2
Country
-- Please Select --
City
Date of departure(dd-mm-yyyy)
/
/
Period 3
Country
-- Please Select --
City
Date of departure(dd-mm-yyyy)
/
/
I understand that I will be required to comply with immigration/alien and other laws
governing entry of immigrants into the country to which I now apply for Visa/Entry permit.
CA
29
* - Compulsory fields
Passport Information
67
Issuing Country*
-- Please Select --
Passport Number*
Date of Issue (dd-mm-yyyy)*
/
/
Expiry Date (dd-mm-yyyy)*
/
Place of Issue*
/
Visa Processing Information
Type of Visa Required*

Business

Transit

Tourist/Visitor

Official

Temporary Employment

STR (Subject To Regularization)
Country Applying From*
Canada
Visa Processing Information
Embassy of Preference (Where applicable)*
-- Please Select --
Purpose of Journey*
Number of entries required*

Single

Multiple
No. of Entries*
Visa processing information
How much money do you have for this trip (USD)*
(Eg: 100)
Intended Duration of Stay (in days)*
Proposed date of travel(dd-mm-yyyy)*
/
/
Mode of travel to Nigeria
If the purpose of your journey to Nigeria is for
employment,state
Name of Employer
Position to be occupied
Full description of job
Give particulars of the employment of parents,
spouse in Nigeria(if applicable)
Name of Employer
Phone number of Employer
How long have your parents/spouse been in Nigeria (in months)
Employer's Address
Address 1
Address 2
City
Country
-- Please Select --
State
Postcode
Intended address in Nigeria
Address 1*
Address 2
City*
Country *
Nigeria
State*
-- Please Select --
LGA
-- Please Select --
District
Postcode
Previous Application Information
Have you ever applied for Nigerian Visa?
No
If Yes, where did you apply for the Visa?
Was the Visa Granted or Rejected?
Granted
If Rejected, please provide reason
Have you ever visited Nigeria?
No
If Yes, for what reason
-- Please Select --
State the period of previous visits to Nigeria and address at
which you stayed
Period 1
From(dd-mm-yyyy)
/
To(dd-mm-yyyy)
/
Address
/
/
Address 1
Address 2
City
Country
Nigeria
State
-- Please Select --
LGA
-- Please Select --
District
Postcode
Period 2
From(dd-mm-yyyy)
/
To(dd-mm-yyyy)
/
Address
Address 1
Address 2
City
Country
Nigeria
State
-- Please Select --
/
/
LGA
-- Please Select --
District
Postcode
Period 3
Address
From(dd-mm-yyyy)
/
To(dd-mm-yyyy)
/
/
/
Address 1
Address 2
City
Country
Nigeria
State
-- Please Select --
LGA
-- Please Select --
District
Postcode
Travel History
How long have you lived in the country from where you are applying for visa (in Years)?*
Have you ever been infected by any contagious disease (e.g. Tuberculosis) or suffered serious
mental illness?*
No
Have you ever been arrested or convicted for an offence (even though subject to pardon)?*
No
Have you ever been involved in narcotic activity?*
No
Have you ever been deported?*
No
If you have ever been deported from which country?*
-- Please Select --
Have you sought to obtain
visa by mis-representation or fraud?*
No
Give a list of the countries you have lived for more than one
year
Period 1
Country
-- Please Select --
City
Date of departure(dd-mm-yyyy)
/
/
Period 2
Country
-- Please Select --
City
Date of departure(dd-mm-yyyy)
/
/
Period 3
Country
-- Please Select --
City
Date of departure(dd-mm-yyyy)
/
/
Give a list of the countries you have visited in the last
twelve(12) months
Period 1
Country
-- Please Select --
City
Date of departure(dd-mm-yyyy)
/
/
Period 2
Country
-- Please Select --
City
Date of departure(dd-mm-yyyy)
/
/
Period 3
Country
-- Please Select --
City
Date of departure(dd-mm-yyyy)
/
/
Travel History
How long have you lived in the country from where you are applying for visa (in Years)?*
Have you ever been infected by any contagious disease (e.g. Tuberculosis) or suffered serious
mental illness?*
No
Have you ever been arrested or convicted for an offence (even though subject to pardon)?*
No
Have you ever been involved in narcotic activity?*
No
Have you ever been deported?*
No
If you have ever been deported from which country?*
-- Please Select --
Have you sought to obtain
visa by mis-representation or fraud?*
No
Give a list of the countries you have lived for more than one year
Period 1
Country
-- Please Select --
City
Date of departure(dd-mm-yyyy)
/
/
Period 2
Country
-- Please Select --
City
Date of departure(dd-mm-yyyy)
/
/
Period 3
Country
-- Please Select --
City
Date of departure(dd-mm-yyyy)
/
/
Give a list of countries you have visited in the last twelve (12) months
Period 1
Country
-- Please Select --
City
Date of departure(dd-mm-yyyy)
/
/
Period 2
Country
-- Please Select --
City
Date of departure(dd-mm-yyyy)
/
Period 3
/
Country
-- Please Select --
City
Date of departure(dd-mm-yyyy)
/
/
I understand that I will be required to comply with immigration/alien and other laws
governing entry of immigrants into the country to which I now apply for Visa/Entry permit.
CA
* - Compulsory fields
29
67