Visa Form Requirement
Personal Details
Personal Details (As in Passport)
1. Surname *
2. Given Names *
3. Date of Birth *
4. Place of Birth *
5. Country of Birth *
South Sudan
6. Gender *
Female
7. Marital Status *
Single
Nationality
A. Dual Nationality *
No
B. Nationality *
Canada
EDIT
Passport Details
8. Passport Type *
Regular Passport
9. Passport No *
10. Place of Issue *
11. Date of Issue *
12. Date of Expiry *
13. Country of Issue *
Canada
EDIT
Requested Visa Type
14. Have you Previously Applied for South Sudan Visa? *
No
15. Visa Type Requested *
Single Entry Visa.
Current Visit Information
16. Purpose of Visit *
Visit
17. Date of Intended Arrival in South Sudan *
18. Duration of Intended Stay in South Sudan *
Less Than 1 Month
19. Date of Departure from South Sudan *
20. Mode of Transport *
Air
21. Select Point of Entry
Juba International Airport
EDIT
Professional / Occupation Details
22. Present Occupation *
23. Occupation Title *
24. Employer Name *
25. Employer Address *
26. Employer Phone No *
27. Employer Email *
EDIT
Applicant’s Contact Details
28. Present Address *
29. Permanent Country of Origin Address *
30. Mobile Number *
31. Alternative Number
32. Applicant Official Email *
EDIT
Family Details
Next of Kin Details
33. name
Surname *
Other Names *
34. Permanent Address *
35. Mobile Number *
36. Email *
EDIT
Travel History
37. Have you ever been convicted of a crime or offense in any country? *
No
38. Have you ever been deported or removed from South Sudan or any country for overstaying your visa or violating any law or regulation? *
No
39. Have you ever been convicted and sentenced for a drug offense in any country in violation of law concerning narcotics, marijuana, opium, stimulants or psychotropic substances? *
No
40. Have you ever committed trafficking in persons or incited or aided another to commit such an offense? *
No
41. Are you suffering from tuberculosis, any other infectious or contagious disease *
No
42. Have you been tested for COVID-19 *
YES
EDIT
Guarantor or references in South Sudan
43. Funds Available For My Stay (US Dollar) *
44. Grantor of Type *
Hotel
Guarantor Details
45. Full Name *
46. Telephone No *
47. eMail *
48. Address *
EDIT
Uploads
49. Passport Photo 2x2 inch *
50. Upload Passport Bio Data Page *
51. COVID-19 Test Certificates *
52. Yellow fever *
53. Upload Guarantor's Reservation *
EDIT
Personal Details (As in Passport)
1. Surname *
2. Given Names *
3. Date of Birth *
4. Place of Birth *
5. Country of Birth *
South Sudan
6. Gender *
Female
7. Marital Status *
Single
Nationality
A. Dual Nationality *
No
B. Nationality *
Canada
EDIT
Passport Details
8. Passport Type *
Regular Passport
9. Passport No *
10. Place of Issue *
11. Date of Issue *
12. Date of Expiry *
13. Country of Issue *
Canada
EDIT
Requested Visa Type
14. Have you Previously Applied for South Sudan Visa? *
No
15. Visa Type Requested *
Single Entry Visa.
Current Visit Information
16. Purpose of Visit *
Visit
17. Date of Intended Arrival in South Sudan *
18. Duration of Intended Stay in South Sudan *
Less Than 1 Month
19. Date of Departure from South Sudan *
20. Mode of Transport *
Air
21. Select Point of Entry
Juba International Airport
EDIT
Professional / Occupation Details
22. Present Occupation *
23. Occupation Title *
24. Employer Name *
25. Employer Address *
26. Employer Phone No *
27. Employer Email *
EDIT
Applicant’s Contact Details
28. Present Address *
29. Permanent Country of Origin Address *
30. Mobile Number *
31. Alternative Number
32. Applicant Official Email *
EDIT
Family Details
Next of Kin Details
33. name
Surname *
Other Names *
34. Permanent Address *
35. Mobile Number *
36. Email *
EDIT
Travel History
37. Have you ever been convicted of a crime or offense in any country? *
No
38. Have you ever been deported or removed from South Sudan or any country for overstaying your visa or violating any law or regulation? *
No
39. Have you ever been convicted and sentenced for a drug offense in any country in violation of law concerning narcotics, marijuana, opium, stimulants or psychotropic substances? *
No
40. Have you ever committed trafficking in persons or incited or aided another to commit such an offense? *
No
41. Are you suffering from tuberculosis, any other infectious or contagious disease *
No
42. Have you been tested for COVID-19 *
YES
EDIT
Guarantor or references in South Sudan
43. Funds Available For My Stay (US Dollar) *
44. Grantor of Type *
Hotel
Guarantor Details
45. Full Name *
46. Telephone No *
47. eMail *
48. Address *
EDIT
Uploads
49. Passport Photo 2x2 inch *
50. Upload Passport Bio Data Page *
51. COVID-19 Test Certificates *
52. Yellow fever *
53. Upload Guarantor's Reservation *
EDIT