Full Name (as in your Vanuatu passport)*
Date of Birth*
Place of Birth*
Gender* MaleFemale
Vanuatu Passport Number*
Vanuatu Passport Issue Date*
Vanuatu Passport Expiry Date*
Residential Address*
Home Address*
Occupation*
Work Address*
Marital Status* SingleMarriedDivorcee
Name(s) of Spouse (as in Vanuatu passport)
Spouse’s Vanuatu Passport Number
Spouse’s Vanuatu Passport Issue Date
Spouse’s Vanuatu Passport Expiry Date
How many children/ dependents do you have?*
Name of child/ dependent
Vanuatu Passport Number
Vanuatu Passport Issue Date
Vanuatu Passport Expiry Date
Name*
Address*
Email*
Relationship to you*
Name
Address
Email
Relationship to you
