<p>Cuban Consulate 32 B Westland Square, Pearse Street, Ireland Dublin 2</p><p>APPLICATION FORM FOR TOURIST CARD</p><p>SURNAME: Mr/Ms/Mrs: ______NAME: ______</p><p>CITIZENSHIP: ______PASSPORT NUMBER: ______</p><p>COUNTRY OF BIRTH: ______DATE OF BIRTH: ______DAY MONTH YEAR</p><p>SEX: F _____ M _____ COUNTRY OF RESIDENCE: ______</p><p>CONTACT DETAILS:</p><p>ADDRESS: ______</p><p>TELEPHONE: (______) ______E-MAIL: ______</p><p>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)</p><p>ARRIVAL POINT: ______(For example: Havana, Varadero, Holguín, and Santiago de Cuba)</p><p>DATE OF ENTRY IN CUBA: ______PROPOSED LENGTH OF STAY: ______DAYS</p><p>ADDRESS IN CUBA: ______</p><p>Please, specify your payment Cash ___ or Money Order______</p><p>DATE: ______SIGNATURE: ______</p><p>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.</p><p>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</p><p>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</p>