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Consulate General of Italy

TORONTO
APPLICATION FORM FOR A SCHENGEN VISA
THIS APPLICATION FORM IS FREE
*
Family members of EU, EEA or CH citizens shall not fill in fields no.21, 22, 30, 31 and 32 (marked with ).
Fields 1‐3 shall be filled in in accordance with the data in the travel document.

1. Surname (Family name): FOR OFFICIAL USE ONLY

APPLICATION DATE
2. Surname at birth (Former family name(s)):
VISA APPLICATION NO.
3. First name(s) (Given name(s)):

4. Date of birth (day-month-year) 5. Place of birth 7. Current nationality:

Application lodged at:

6. Country of birth □ Consulate

Nationality at birth, if different:
□ CAC

Other nationalities: □ Service provider

8. Sex 9. Marital status □ Commercial intermediary
□ MALE □ FEMALE □ Single □ Married □ Registered Partnership □ Separated □
Divorced □ Widow(er) □ Other (please specify): □ Border
10. Parental authority (in case of minors) /legal guardian (surname, first name, address, if different from applicant’s,
telephone no., e mail address, and nationality): Name:

□ Other

FILE HANDLED BY:

11. National identity number, where applicable:

12. Type of travel document:

□ Ordinary passport □ Diplomatic passport □ Service passport □ Official passport □ Special passport SUPPORTING DOCUMENTS
□ Other travel document (please specify)
13. Number of travel document: 14.date of issue 15. Valid until: 16. Issued by (country): □ Travel document

□ Financial means

17. Personal data of the family member who is an EU, EEA or CH citizen if applicable □ Invitation
Surname (Family name): First name(s) (Given name(s)): □ Means of transport

□ TMI
Date of birth Nationality: Number of travel document or ID card:
□ Other
(day-month-year):
VISA DECISION

18. Family relationship with an EU, EEA or CH citizen if applicable: □ Refused

□ spouse □ child □ grandchild □ dependent ascendant □ Issued:

□ Registered Partnership □ other:
□A
19. Applicant's home address and e mail address: Telephone no.:
□C

□ LTV

20. Residence in a country other than the country of current nationality: Valid from:
□ No
□ Yes. Residence permit or equivalent ………………… No. …………………….. Valid until…………… Until:
*21. Current occupation:

* 22. Employer and employer’s address and telephone number. For students, name and address of educational NUMBER OF ENTRIES
establishment: □1 □ 2 □ Multiple

NUMBER OF DAYS:
23. Purpose(s) of the journey:
□ Tourism □ Business □ Visiting family or friends □ Cultural □ Sports □ Official visit □ Medical reasons □ Study □ Airport
transit □ Other (please specify):

24. Additional information on purpose of stay:

25. Member State of main destination (and other Member States of destination, 26. Member State of first entry:
if applicable):
27. Number of entries requested:

□ Single entry □ Two entries □ Multiple entries

Intended date of arrival of the first intended stay in the Schengen area:

Intended date of departure from the Schengen area after the first intended stay:
28. Fingerprints collected previously for the purpose of applying for a Schengen visa:
□ No □ Yes.

Date, if known …………………….. Visa sticker number, if known ………………………………………………

29. Entry permit for the final country of destination, where applicable:
Issued by ………………………………..Valid from ……………………until ……………………

* 30. Surname and first name of the inviting person(s) in the Member State(s). If not applicable, name of hotel(s) or
temporary accommodation(s) in the Member State(s):
Address and e mail address of inviting person(s)/hotel(s)/temporary Telephone no.:
accommodation(s):

*31. Name and address of inviting company/organisation:

Surname, first name, address, telephone no., and e mail address of contact Telephone no. of
person in company/organisation: company/organisation:

*32. Cost of travelling and living during the applicant’s stay is covered:
□ by the applicant himself/herself □ by a sponsor (host, company, organisation), please specify:
…….□ referred to in field 30 or 31
Means of support: …….□ other (please specify):
□ Cash Means of support:
□ Traveller’s cheques □ Cash
□ Credit card □ Accommodation provided
□ Pre paid accommodation □ All expenses covered during the stay
□ Pre paid transport □ Pre paid transport
□ Other (please specify): □ Other (please specify):

I am aware that the visa fee is not refunded if the visa is refused.

Applicable in case a multiple entry visa is applied for:

I am aware of the need to have an adequate travel medical insurance for my first stay and any subsequent visits to the territory of Member
States.

I am aware of and consent to the following:

the collection of the data required by this application form and the taking of my photograph and, if applicable, the taking of fingerprints, are
mandatory for the examination of the application; and any personal data concerning me which appear on the application form, as well as my
fingerprints and my photograph will be supplied to the relevant authorities of the Member States and processed by those authorities, for the
purposes of a decision on my application.
Such data as well as data concerning the decision taken on my application or a decision whether to annul, revoke or extend a visa issued will
be entered into, and stored in the Visa Information System (VIS) for a maximum period of five years, during which it will be accessible to the
visa authorities and the authorities competent for carrying out checks on visas at external borders and within the Member States, immigration
and asylum authorities in the Member States for the purposes of verifying whether the conditions for the legal entry into, stay and residence on
the territory of the Member States are fulfilled, of identifying persons who do not or who no longer fulfil these conditions, of examining an
asylum application and of determining responsibility for such examination. Under certain conditions the data will be also available to
designated authorities of the Member States and to Europol for the purpose of the prevention, detection and investigation of terrorist offences
and of other serious criminal offences. The authority of the Member State responsible for processing the data is:
[(………………………………………………………………………………………………………………………)].

I am aware that I have the right to obtain, in any of the Member States, notification of the data relating to me recorded in the VIS and of the
Member State which transmitted the data, and to request that data relating to me which are inaccurate be corrected and that data relating to
me processed unlawfully be deleted. At my express request, the authority examining my application will inform me of the manner in which I
may exercise my right to check the personal data concerning me and have them corrected or deleted, including the related remedies
according to the national law of the Member State concerned. The national supervisory authority of that Member State [contact details:
………………………………………………………………………………………..] will hear claims concerning the protection of personal data.
I declare that to the best of my knowledge all particulars supplied by me are correct and complete. I am aware that any false statements will
lead to my application being rejected or to the annulment of a visa already granted and may also render me liable to prosecution under the law
of the Member State which deals with the application.
I undertake to leave the territory of the Member States before the expiry of the visa, if granted. I have been informed that possession of a visa
is only one of the prerequisites for entry into the European territory of the Member States. The mere fact that a visa has been granted to me
does not mean that I will be entitled to compensation if I fail to comply with the relevant provisions of Article 6(1) of Regulation (EU) No
2016/399 (Schengen Borders Code) and I am therefore refused entry. The prerequisites for entry will be checked again on entry into the
European territory of the Member States.
Place and date: Signature:
(signature of parental authority/legal guardian, if
applicable):