Cuban Consulate 32 B Westland Square, Pearse Street, Ireland Dublin 2

APPLICATION FORM FOR TOURIST CARD

SURNAME: Mr/Ms/Mrs: ______NAME: ______

CITIZENSHIP: ______PASSPORT NUMBER: ______

COUNTRY OF BIRTH: ______DATE OF BIRTH: ______DAY MONTH YEAR

SEX: F _____ M _____ COUNTRY OF RESIDENCE: ______

CONTACT DETAILS:

ADDRESS: ______

TELEPHONE: (______) ______E-MAIL: ______

HAVE YOU BEEN TO CUBA: ______IF YES, DATE OF LAST ENTRY: ______DAY MONTH YEAR BOARDING POINT: ______(Eg: Amsterdam, Toronto, Heathrow, Madrid, Paris, Mexico or any other transit point)

ARRIVAL POINT: ______(For example: Havana, Varadero, Holguín, and Santiago de Cuba)

DATE OF ENTRY IN CUBA: ______PROPOSED LENGTH OF STAY: ______DAYS

ADDRESS IN CUBA: ______

Please, specify your payment Cash ___ or Money Order______

DATE: ______SIGNATURE: ______

WHEN APPLYING YOU MUST SUBMITT:  Photocopy of the main page of your passport and (valid for 6 month after the departure from Cuba).  Photocopy of your travel health insurance documents.  Photocopy of your ticket in and out or letter of your travel agent confirming you have a flight ticket.  If applying by post, a self-address registered envelope is required to send the visa back to you.  A Tourist Card fee of 22.00 Euros, cash, payable to the Cuban Consulate. If applying by post: money order (cash is not acceptable by post). If you have any enquires please phone (01) 671 8300, (01) 671 8320. Office hours: Monday, Wednesday and Thursday 9:30am 13:30pm.

Note: If you apply either by post or on behalf of another person, payment of an additional 25.00 EUR fee applies. E.g. €22.00 visa fee + €25.00 additional fee = 47 euros per person

Tourist Cards are issued for ONE entry in Cuba, for a maximum of 30 days. Longer stays will require extensions made in Cuba. Application form updated 2016