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VISA APPLICATION FORM

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Select No Visa
GENERAL
Port of Entry to Indonesia
Date of Entry
Length of Stay in Indonesia Day(s) Month(s) Year(s)
Type of Visa Single Visit Transit Limited Stay Multiple Visit
Multiple & Limited Visas Required Imigration's Approval/Authorization
FOR VISIT PURPOSE
Type of Visa
Country of Destination
Place of Visit
Flight/Vessel Name & No
FOR TRANSIT PURPOSE
Country of Destination
Place of Visit
Flight/Vessel Name & No
FOR LIMITED STAY PURPOSE
Purpose of Stay Tourism Convention Family Sports
Addres in Indonesia
City
Phone Number
PERSONAL DATA
Name
Sex
Status
Place of Birth
Date of Birth
Nationality
Address in Bahrain
Area Block Road Bldg Flat
Occupation
Name of Company
Address
City
Phone Number
Email
PASSPORT INFORMATION
Passport/Travel document
number
Place of Issue
Date of Issue
Date of Expire
Type of Passport
Family Details for Holder of Family Passport :
No Relation Sex Date of Birth Name
1
2
3
City
Phone Number
SPONSORSHIP IN INDONESIA
Type of Sponsor
Sponsors Name
Address
City
Phone Number
Required documents which should be submitted are as follows (File allows jpg, png) | maximun file 1 MB
Upload Foto
Passport
Bahrain Residence Permit
One coloured passport size photograph
Sponsorship Letter
Invitation Letter
Travel itinerary
Hotel Reservation
Bank Statement
CPR
MISCELLANEOUS (please circle the answer)
Have you ever been to Indonesia before ? : Yes No
Are you in possession of other countries Travel Document ? : Yes No
Do you have previous visa to enter Indonesia? : Yes No
Have you ever been forced to leave Indonesia? : Yes No
Have you ever been commited a crime or any offence? : Yes No
Return/Through Ticket/Airlines Company
Place of Issue
Date of Issue
Date of Expire

For Afghanistan, Guinea, Israel, Liberia, Nigeria, Somalia and Cameron Nationality Should have approval from Imigration Office In Jakarta Indonesia.

I hereby declare that the statements givenabove are true and I understand that even if granted visa, admission at the airport/seaport remains the discretion of the Imiigration Authorities in Indonesia.

Note : Fees for Visa application is non-refundable.