Application for a Special Category Visa - Page 1 / 11

The price for Special Category Visa is between 75 AUD and 150AUD.

Payment must be done before we process the application. This must be treated as purchasing a product, it is a service but we must receive the payment, before we can process the application. For example if you deposit your application at the Australian High Commissioner or NZH payment must be done straight way.

1 - How many people are included in this application?

Number of people included in this application

2 - Give your details as shown on your passport.

Family Name

Given Name

3 - Have you been known by any other name?

If yes : Please give details and provide supporting documentation

Other name Yes No

Family Name

Given Name

4 - Gender Male Female

5 - Date of birth

6 - Place of birth

Town/city

Country

7 - Nationality

8 - Details of your passport

Country of passport

Passport number

Place of issue

Date of Issue

Date of Expiry

9 - Do you hold any other citizenship?

Do you hold any other citizenship? Yes No

If yes, please specify

Application for a Special Category Visa - Page 2 / 11

10 - Relationship Status

Relationship Status

Married

De facto

Engaged

Separated

Divorced

Widowed

Single

Name of partner/ spouse/ fiancée

Date of birth

11 - Your country of usual residence

Your country of usual residence

12 - Your residential address in your country of usual residence

Your residential address in your country of usual residence

13. Your telephone numbers outside Vanuatu (include country and area code)

Office hours

After hours

14. Address for correspondence

15 - Do you agree to Vanuatu Immigration communicating with you, or

your authorised representative, by fax or e-mail?

Do you agree ? Yes No

If yes, please give details

Fax number

E-mail address

Application for a Special Category Visa - Page 3 / 11

Previous Visa Applications

16 - Please give details of your family members included in this application

Members of your family may include your spouse or de-facto partner and your dependent children.

Family Member A

Family Name

Given Names

Date of Birth

Country of Passport

Passport Number

Place of Issue

Date of Issue

Date of Expiry

Family Member B

Family Name

Given Names

Date of Birth

Country of Passport

Passport Number

Place of Issue

Date of Issue

Date of Expiry

Family Member C

Family Name

Given Names

Date of Birth

Country of Passport

Passport Number

Place of Issue

Date of Issue

Date of Expiry

Family Member D

Family Name

Given Names

Date of Birth

Country of Passport

Passport Number

Place of Issue

Date of Issue

Date of Expiry

If you have more than 4 family members included in your application please attach a page to your application with the required information asked above.

Application for a Special Category Visa - Page 4 / 11

Family members included in your application who are under 18 years of age

17 - If the family member included in your application is aged under 18 years of age, do you have the sole right to determine where they will live? Yes No

If no, please give details of any other person who has this right

Family Name

Given Names

Date of Birth

Address

Telephone

Relationship to dependent applicant

Basis of legal right

18 - Are your dependants subject to a court order giving you the sole right to determine where they live or to remove them from their country of residence? Yes No

If yes, please attach a copy of the court order

Application for a Special Category Visa - Page 5 / 11

Details of the purpose of your stay in Vanuatu

19 - What is the purpose of your stay in Vanuatu?

Diplomatic representative in Vanuatu

Please specify

Please attach letter from the Ministry of Foreign Affairs approving your stay in Vanuatu

Go to Question 22

Employee/Secondment to Government Department

Please specify Department

Please attach letter from the relevant Commissioner approving your stay in Vanuatu

Go to Question 22

Member of a 'donor agency'

Please specify donor agency

20 - Is the donor agency or Department of a foreign Government? Yes No

If no, go to Question 21

If yes, go to Question 22

Information about the donor agency

21 - Please specify in detail:

a) The development assistance that the donor agency is providing to Vanuatu;

b) Your role in Vanuatu as a member of the donor agency

Please attach a letter from your donor agency in support of your stay in Vanuatu. The letter must indicate:

- the purpose of the organisation

- indicate that the organisation is operating in Vanuatu on a not-for-profit basis

- your role/the purpose of your stay in Vanuatu

Application for a Special Category Visa - Page 6 / 11

22 - Your intended date of arrival and departure?

Date from

Date to

23 - Your intended address and telephone number in Vanuatu (if known)

Address

Telephone

24 - Have you previously spent any time in Vanuatu?

Have you previously spent any time in Vanuatu? Yes No

If yes, please give the following details

Period 1

From

Type of Visa held

Period 2

From

Type of Visa held

Period 3

From

Type of Visa held

25 - Have you ever been refused a visa to come to Vanuatu?

19. Have you ever been refused a visa to come to Vanuatu? Yes No

If yes, please give details

Application for a Special Category Visa - Page 7 / 11

Health and Character

26 - Have you or any person included in this application ever had or currently have tuberculosis? or been in contact with a person who has active tuberculosis?

currently have tuberculosis? or been in contact with a person who has active tuberculosis?

or been in close contact with a person who has active tuberculosis? Yes No

If yes, please give details

27 - Are you suffering from a contagious disease and/or a mental illness?

Are you suffering from a contagious disease and/or a mental illness? Yes No

If yes, please give details

Application for a Special Category Visa - Page 8 / 11

28 - Have you or any person included in your application ever

- been convicted of a criminal offence in any country? Yes No

- been charged with an offence that is currently awaiting legal action? Yes No

- been acquitted of any offence on the grounds of mental illness, insanity or unsoundness of mind and as a result been detained in a facility or institution? Yes No

- been removed or are you in the process of removal from any country (including Vanuatu)? Yes No

- left any country to avoid being prosecuted for an offence in that country or to avoid being removed or deported? Yes No

- had, or do you have, an association with another person or with a group or organisation that is or has been involved in criminal conduct? Yes No

- been involved in any activities that would represent a risk to the security and defence of Vanuatu? Yes No

- been involved in any activity relating to the illegal movement of people to any country? Yes No

- served in a military force or militia, undergone any military/paramilitary training, or been trained in weapons/explosives use? Yes No

- Do you have any outstanding debts to the government of Vanuatu? Yes No

If you answered 'Yes' to any of the above questions, you must give ALL the relevant details. If the matter relates to a criminal conviction, please give the nature of the offence, full details of sentence and dates of any period of imprisonment or other detention.

Please give details

Application for a Special Category Visa - Page 9 / 11

Declaration

The declaration below must be signed by applicants over the age of 18. Both parents, if living, or legal guardian(s) must complete the declaration on behalf of any child under 18 years of age or any person who lacks the legal capacity to sign on their own behalf.

I am aware that giving false or misleading information is a serious offence and may result in a conviction resulting in a fine or imprisonment, the refusal of this visa application or the cancellation of any associated visa.

I certify the information supplied on and with this form is correct.

If granted a visa I will abide by all laws of Vanuatu and the conditions of the visa (as specified in the Information section on the front page of this form).

I will immediately advise Vanuatu Immigration if I become aware that any information provided in this form is incorrect or if there is a change in my personal or economic circumstances.

29 - Declaration

Signature of applicant

Date

Signature

Date

Signature

Date

Signature

Date

Application for a Special Category Visa - Page 10 / 11

30 - Consent to correspond with authorised representative (if applicable)

Through my signature at question 32 above I consent to the Vanuatu Immigration Service corresponding with the following person who is my authorised representative or agent. I understand that this may extend to the provision of personal information about me if relevant to this application.

Name and address of authorised representative

Telephone number

Fax number

E-mail address

Application for a Special Category Visa - Page 11 / 11

Download Section

You can upload your files (passport, picture, etc) now or we will ask you to send them by email

Upload your files

You can submit the form and we will contact you for the payment.

Human ?

Application for a Special Category Visa : Done !

Thanks you,

We will contact you after reviewing your application with questions or agreement normally within the next 36 hours.

Best regards,
The Global Immigration Team

Files submitted, sending form data now. Please do not abort!