Applicant Information

All information should be entered as per the applicant's passport

Surname/Family Name

Other/Given Names

Title

Date of Birth

Gender

Nationality

Country of Birth

Occupation

Passport Number

Passport Issuing Date

Passport Expiry Date

Child information in parent's passport

Enable

Children under 16 years of age possessing separate passport(s) should submit individual application(s)

Surname/Family Name

Other/Given Names

Date of Birth

Gender

Intended Arrival Date

Purpose of Visit

Port of Departure

Airline / Vessel

Flight / Vessel Number

Address Line 1

Address Line 2

City

State

Zip/Postal Code

Country

Address in Sri Lanka

Email Address

Telephone Number

Mobile Number

Fax Number

Yes

2 . Are you currently in Sri Lanka with a valid ETA or obtained an extension of visa? *

Yes

Yes

Please consider information you entered before confirm

I would like to confirm the above information is correct. *