Applicats information

WARNING!!! INCORRECTLY COMPLETED INFORMATION CAN BE THE REASON FOR REFUSED TO OBTAIN A
WORK VISA TO THE UNITED KINGDOM.
ALL INFORMATION SHOULD BE COMPLETED ONLY IN ENGLISH!
Given Name
Last Name (Surname)
Middle Names
Nationality Indonesia
Place of Birth Tohpati
Country of Birth Indonesia
Date of birth (d.m.y) 04.09.2000
Gender (M/F) Female
Country of Residence
Current passport or travel document number
Date of issue
Date of expiry
Issuing authority
Place of issue
Your permanent residential address (House Dusun Kawan, Desa Tohpati, Banjarangkan, Klungkung
No/Flat/Street) 16 Voskresenskaya street, Apt. 3
City/Town/Village
Area/Region
Post Code
Country Indonesia
Phone number 083 115 199 078
Email adrress Luhhnikk04@gmail.com
What is your marital status (Married Single
/Single)
Do you have children? If yes, what are their No
names and DOB? (Yes/No)
Do you have direct relatives in the UK?
What is their address and phone number. Do
you plan to visit them?(Yes / No )
Name and phone number for an emergency
contact (in your country)
Have you been granted a UK visa before?
(Yes/ No)
If Yes, indicate the effective date of your
last visa
Have you ever traveled to the UK before? /
(Yes/No) If YES, please indicate the type of
visa, date, duration and purpose of stay.
Which airport / border crossing point?
Ground, air transport?
Have you been or worked illegally in the
UK? (Yes/ No)
Have you ever been refused a visa for the
UK? (Yes/ No)
Have you ever been deported‚ removed or
otherwise required to leave the UK (Yes/
No)
Are your other UK visa applications valid at
the moment? Is there an appeal over the
refusal of a visa to the UK (Yes/Noт)
Have you ever travelled outside your
country or residence‚ in the last 10 years?/
(Yes/ No) SAMPLE:
Poland - season work - 18.08.2017-
8.12.2017. Norway - tourism - 20.11.2019-
30.11.2019
Do you have any criminal convictions in
any country? (Yes/No)
Are you able to commit to six months of
work in the UK? (Yes /No)
Why would you return to your home after
your UK visa expires?
Do you have health problems that can affect
your ability to do the job? (Yes/No)
Father's given name and family name
Father's date of birth
Mother's given name and family
Mother's date of birth
Date of completion