AFRINEXA GLOBAL LIMITED

Visa Application & Client Information Form

Please complete all fields accurately. Incomplete forms will not be processed.

IMPORTANT NOTICE: All information provided must be truthful and accurate. Submission of false or misleading information may result in visa refusal and legal consequences. This form is for consultancy purposes only.

Applicant Personal Information

Full Name *

Date of Birth *

Gender *

Nationality *

Marital Status *

Passport Number *

Passport Expiry Date *

Residential Address *

Phone Number *

Email Address *

Travel Information

Destination Country *

Purpose of Travel *

Intended Travel Date *

Duration of Stay *

Previous International Travel History

Previous Visa Refusal History *

Employment / Business Information

Occupation *

Employer / Business Name

Office / Business Address

Monthly Income

Emergency Contact Information

Full Name *

Relationship *

Phone Number *

Address *

Document Uploads

Upload clear, legible scans or photos. Accepted formats: PDF, JPG, PNG. Maximum file size: 10MB per file. Ensure all documents are valid and not expired.

Passport Scan (Bio-Data Page) *

Upload a clear scan of your passport bio-data page showing your photo and personal details.

Click to upload file

PDF, JPG, PNG up to 10MB each

Financial Statement / Bank Statement

Upload your most recent 3–6 months bank statement or proof of financial means.

Click to upload file

PDF, JPG, PNG up to 10MB each

Supporting Documents

Upload any additional supporting documents (e.g. employment letter, invitation letter, hotel booking, flight itinerary, travel insurance). You may upload multiple files.

Click to upload files

PDF, JPG, PNG up to 10MB each

Declaration & Disclaimer

PLEASE READ CAREFULLY BEFORE SIGNING

I, the undersigned applicant, hereby declare and confirm that all information provided in this Visa Application and Client Information Form is true, complete, accurate, and correct to the best of my knowledge and belief. I understand that any false, misleading, or incomplete information may result in the refusal of my visa application and may have legal consequences.

IMPORTANT DISCLAIMER — PLEASE READ AND ACKNOWLEDGE:

Non-Issuing Authority: Afrinexa Global Limited is a private visa and travel consultancy firm. We are NOT a visa-issuing authority, embassy, consulate, high commission, or immigration office. We do not have the authority to grant, approve, or guarantee any visa application.
Embassy Discretion: All visa approvals, refusals, deferrals, requests for additional documentation, or any other decisions relating to visa applications are made solely at the absolute discretion of the relevant embassy, consulate, high commission, immigration authority, or visa officer of the destination country.
Processing Timelines: Government policies, immigration regulations, administrative processing procedures, security screening, background checks, and internal embassy procedures may significantly affect visa processing timelines. Afrinexa Global Limited does not control and cannot predict or guarantee processing timelines.
Limitation of Liability: Afrinexa Global Limited shall not be held liable, responsible, or accountable for any visa refusal, delay, cancellation, policy change, embassy decision, or any other outcome that is beyond our direct control. Our role is limited to providing professional consultancy, documentation guidance, and application support services.
Service Fees: Consultancy service fees paid to Afrinexa Global Limited are for professional advisory and documentation support services only. These fees are non-refundable in the event of a visa refusal, delay, or any embassy decision, as our services are rendered regardless of the outcome.
Applicant Responsibility: The applicant bears full responsibility for the accuracy and completeness of all information and documents submitted. Afrinexa Global Limited shall not be held responsible for errors, omissions, or inaccuracies arising from information provided by the applicant.

By signing below, I confirm that I have read, understood, and fully accept all the terms and conditions stated in this declaration and disclaimer. I consent to the processing of my personal information for visa consultancy purposes in accordance with applicable data protection laws.

I have read, understood, and I fully accept the Declaration and Disclaimer above. I confirm that all information provided is true and accurate to the best of my knowledge.

Signature Section

Applicant Signature (Full Name) *

Typing your full name constitutes your electronic signature.

Date *

— FOR OFFICIAL USE ONLY —

Application Reference No.

Received By

Date Received

Consultant Assigned

Processing Status

Remarks

By submitting this form, you confirm your agreement to the declaration above. Your data and documents are handled securely and used solely for visa consultancy purposes.

Afrinexa Global Limited · No. 44 University Road, Tanke, Ilorin, Kwara State, Nigeria

Tel: +234 815 102 2244 · Email: info@afrinexaglobal.com · Web: afrinexaglobal.com