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KAZAKHSTAN VISA ONLINE APPLICATION

  All fields marked * are REQUIRED.
  VISA TYPE
SELECT VISA TYPE ->  
  VISA APPLICATION
* Last Name
* First Name and Middle Name
* Gender

Male
Female

* Citizenship
* Marital status

Single
Married
Divorced
Widowed

   Spouse full name (if any)
   Spouse citizenship
* Date of birth
* Place of Birth
* Passport Type

Regular
Diplomatic
Travel Document

* Passport Number
* Passport issue date
* Passport expiration date
* Passport issued by
* Have you been to Kazkahstan before?

Yes
No

* Trip Purpose

Tourism
Business

* Date of entry
* Date of departure
* Work address
   Work phone number
* Temporary address in Kazakstan
   Person arranging visit to Kazakstan
* Have you got an insurance for the period of stay?

Yes
No

   If yes, indicate its validity and the name of insurance
  Applicant Information (Billing address)
* Company Name:
* Employment Title/Position
* Home Address:
* City:
* State:
* Zip:
* Home Phone:
   Day Phone:
* E-Mail Address:
  Ship to address (if different from above)
   Name:
   Company Name:
   Shipping Address:
   City:
   State:
   Zip:
   Phone:
  Travel Information
* Earliest Known Date of Departure from USA
* Please enter cities you intend to travel to
  Shipping & Handling (per person)
* Please, choose your return shipping method (per person)
   Signature

Signature Release on Delivery
Signature Required on Delivery

  Payment Information
* Form of Payment:
   Credit card holder's name
   Credit Card Number:
   Credit Card Expiration Date:
  Comments
   Special Request / Comments
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