Professional Documents
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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: MIGUELREVECO@OUTLOOK.COM
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 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);
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:
For further information on the programme, please refer to the FAQs posted on
the Embassys website: http://www.embassyofireland.org.ar/