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MIGUEL REVECO Ireland Chile WHA Application Form

Miguel Reveco Moreno, a male citizen of Venezuela, has applied for a Working Holiday Authorisation to visit Chile in 2017. He declares that he has never suffered from a communicable disease, been addicted to or trafficked narcotics, or been convicted of a criminal offense. He agrees to the terms that he will support himself financially, have valid medical insurance, register with authorities upon arrival, not be accompanied by dependents, limit his visit to 12 months, and leave upon expiration of the authorization without extension. He is required to submit this completed application, photos, valid passport copy, and police background check to the proper authorities per the application process.

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165 views2 pages

MIGUEL REVECO Ireland Chile WHA Application Form

Miguel Reveco Moreno, a male citizen of Venezuela, has applied for a Working Holiday Authorisation to visit Chile in 2017. He declares that he has never suffered from a communicable disease, been addicted to or trafficked narcotics, or been convicted of a criminal offense. He agrees to the terms that he will support himself financially, have valid medical insurance, register with authorities upon arrival, not be accompanied by dependents, limit his visit to 12 months, and leave upon expiration of the authorization without extension. He is required to submit this completed application, photos, valid passport copy, and police background check to the proper authorities per the application process.

Uploaded by

Miguel A Reveco
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as RTF, PDF, TXT or read online on Scribd
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APPLICATION FOR A WORKING HOLIDAY

AUTHORISATION CHILE - 2017

Please complete this form in English using block capital letters

PERSONAL DETAILS
Family Name: MIGUEL
First Names: REVECO MORENO
Date and Place of Birth: CARACAS, VENEZUELA
Male/Female: MALE
Passport Number: 22868070-2 Valid Until: 21/03/2018
Present Address: CUATRO NORTE #816. INDEPENDENCIA,
SANTIAGO
Telephone: +56 9 58713633
E-mail: [email protected]

DECLARATION
Have you at any time:
Suffered from any communicable disease, such as tuberculosis? YES NO X
Used, been addicted to, or trafficked in narcotics? YES NO X
Been convicted of a criminal offence in any country? YES NO X
Been deported or excluded from any country? YES NO X
I agree to the following terms and conditions:

I have sufficient funds, or access to such funds, to support myself during a


substantial part of my visit; and that I may be required to produce evidence to
this effect by the Immigration Officer at port of entry;

I understand that medical insurance valid for the duration of my time in Ireland
is a requirement, and may be requested by an Immigration Officer at the port of
entry;

Working Holiday Authorisations for citizens of Chile are valid for presentation
at an Irish port of entry within twelve months of the date of issue;

Within the time frame specified by the Immigration Officer at the port of entry,
holders of Working Holiday Authorisations must register with the Garda
National Immigration Bureau and will be issued with a Certificate of
Registration on payment of the appropriate fee (300) an on production of all
relevant supporting documentation (which includes proof of funds, medical
insurance, and police certificate);

Working Holiday Authorisations are issued on an individual basis. Holders of


Working Holiday Authorisations shall not seek to be accompanied or joined by a
spouse or dependents;

Permission granted to those entering Ireland on the basis of a Working Holiday


Authorisation shall be valid for a maximum period of twelve (12) months from
the date of entry into Ireland. Extensions to the period of validity of such
permission shall not be granted. Participants must leave Ireland on the
expiration of the permission, which cannot be extended, either under the
authorisation itself, or through attempting to convert it to a different form of
immigration status. I understand I may be requested to produce a return ticket
(as evidence of compliance with 12 month limit of authorisation) at the port of
entry;

Chilean nationals who are already in Ireland with an immigration status other
than that based on a Working Holiday Authorisation may not convert to
permission based on a Working Holiday Authorisation without leaving the
State and re-entering on the basis of the valid Working Holiday Authorisation.

All questions have been answered and the particulars provided are true and
correct to the best of my knowledge.

Signed: 28/11/2016

Date:

DOCUMENTATION REQUIRED
This fully completed and signed application form should be presented in
accordance with the application procedure, details of which are available on
**VFS website** together with the following:

2 recent passport-sized photographs


Valid Chilean passport (+ photocopy of details page)
A police certificate of good conduct (Certificado de Antecedentes Penales).

For further information on the programme, please refer to the FAQs posted on
the Embassys website: http://www.embassyofireland.org.ar/

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