Instructions for Completing the National Visa Application Question on Visa Answer: Example: Application: 1. Surname(s) Your last name Williams 2. Surname at birth Maiden name or last name at Williams (previous surname(s)) birth 3. Forename(s) First and middle name Karen Michelle 4. Date of birth (day- Your birth date (day-month- 25-2-1991 OR month-year) year) 25-February-1991 5. Place of Birth City and State Des Moines, Iowa 6. Country of birth Country of birth U.S.A 7. Current nationality/ Your nationality American Nationality at birth 8. Sex Your gender Female 9. Marital Status Your marital status Single 10. For minors… If you’re a minor (under 18), list N/A your guardian’s info here 11. National identity number Your Social Security Number N/A 12. Type of travel document Check “Ordinary Passport” “Ordinary Passport” 13. Number of travel Your passport number 456789012 document 14. Date of issue Your passport’s issue date 25-3-2010 15. Valid until Your passport’s valid until date 24-3-2020 16. Issued by Agency that issued your U.S. Department of State passport 17. Applicant’s home Your home address, email and 301 Camp Craft Rd Ste 100, address & email – telephone Austin, TX 78746 Telephone number [email protected] 512-600-8900 18. Residence in a Select applicable answer No country… 19. Current occupation List occupation Student 20. Main purpose… Check “Studies” “Studies” 21. Intended date of arrival Enter program’s start date – 1-9-2012 OR even if you plan to travel 1-September-2012 before 22. Number of Entries… Check “More than two” “More than two” 23. Applicant’s address in Barcelona Students: Hotel Regina Spain Hotel HCC Montblanc C/ Alcalá nº 19 Via Laietana, 61 28014 Madrid, Spain 08003 Barcelona All Other Students: Hotel Regina C/ Alcalá nº 19 28014 Madrid, Spain 24. Spanish Foreign… Write N/A “N/A” 25. Date of notification… Write N/A “N/A” 26. Data of the individual… Write N/A “N/A” 27. Data of the employer… Write N/A “N/A” 28. Data of the educational Write the address of the Pablo de Olavide University establishment… institution you will be studying Ctra. Utrera, Km 1 at. 41013 Sevilla, Spain 011-34-954349200 Barcelona: [email protected] University Autonoma of Barcelona C/ Sant Antoni Maria Claret, 171 08041 Barcelona, Spain 011-34-935811111 [email protected] University of Barcelona Plaza de la Universidad 08071 Barcelona, Spain 011-34-934 021 100 [email protected] Pompeu Fabra University Plaça de la Mercé, 10-12 08002 Barcelona, Spain 011-34- 935422000 [email protected] Bilbao: University of Deusto Avenida de las Universidades 24 48007 Bilbao, Spain 011-34- 943 326 600 [email protected] University of the Basque Country Campus de LEIOA Barrio de Sarriena s/n 48940 Leioa-Bizkaia, Spain 011-34- 946012000 [email protected] Cadiz: University of Cadiz Centro Superior de Lenguas Modernas (CSLM) Aulario La Bomba 11003 Cadiz, Spain 011-34-956015350 [email protected] Granada: University of Granada Placeta del Hospicio Viejo s/n 18009 Granada, Spain 011-34-958 243025 [email protected] Madrid: Antonio De Nebrija University Campus de la Dehesa de la Villa C/ Pirineos, 55 28040 Madrid, Spain 011-34-902321322 [email protected] Complutense University Facultad de Filosofia y Letras, Edificio A Ciudad Universitaria 28040 Madrid, Spain 011-34-914520400 [email protected] Suffolk University Calle de la Vina 3 28003 Madrid, Spain 011-34-915335935 [email protected] Salamanca: University of Salamanca Patio de Escuelas Menores 37008 Salamanca, Spain 011-34-923294400 [email protected] Seville: Pablo de Olavide University Ctra. Utrera, Km 1 41013 Sevilla, Spain 011-34-954349200 [email protected] University of Seville Calle Palos de la Frontera s/n 41004 Sevilla, Spain 011-34-954551128 [email protected] 27. Place and Date Fill in the place & date where Austin, TX 1-April-2012 the form was signed (If using API’s visa service fill in where and when the form was notarized) 28. Signature Sign name (at consulate or in Karen Williams front of notary) ! .