Israel Ministry of Foreign Affairs — Entry Visa to Israel Application Form

Fields

• familyName string required

  Applicant's family name.

• givenName string required

  Applicant's given name.

• fathersName string required

  Applicant's father's name.

• mothersName string required

  Applicant's mother's name.

• previousFamilyName string optional

  Any previous family name(s) the applicant has used.

• placeOfBirth string required

  Applicant's place of birth.

• dateOfBirth date required

  Applicant's date of birth.

• occupation string required

  Applicant's occupation.

• presentNationality string required

  Applicant's present nationality.

• previousNationality string optional

  Applicant's previous nationality, if any.

• documentType enum required

  Whether the travel document the applicant holds and will travel on is a national passport or a laissez-passer. The form prints this choice as two mirrored checkbox pairs (one Hebrew-labelled, one English-labelled) for the same two options; both mirrors are modelled as a single field, following this registry's established convention for this jurisdiction's bilingual mirrored checkboxes (see il/moin/dr1-passport-application).

  enum: PASSPORT | LAISSEZ_PASSER
• gender enum required

  Applicant's gender.

  enum: MALE | FEMALE
• familyStatus enum required

  Applicant's family status.

  enum: MARRIED | SINGLE | WIDOWED | DIVORCED
• documentNumber string required

  The document number of the passport or laissez-passer named in documentType.

• documentIssuedBy string required

  The authority that issued the document.

• documentIssuedOn date required

  The date the document was issued.

• documentValidUntil date required

  The date the document expires.

• returnVisaDetails string optional

  Whether the applicant holds a return visa to their country of permanent residence, and its validity. The form directs this at applicants travelling on a laissez-passer issued by their state of permanent residence.

• permanentAddressCountry string required

  Country of the applicant's permanent address abroad.

• permanentAddressCity string required

  City of the applicant's permanent address abroad.

• permanentAddressStreetAndHouseNumber string required

  Street and house number of the applicant's permanent address abroad.

• telephoneNumber string optional

  Applicant's telephone (landline) number.

• mobilePhoneNumber1 string optional

  Applicant's mobile phone number. The source form prints two identically-labelled "מס' טלפון נייד" / "Mobile No." columns with no distinguishing sub-label; modelled as two generically-ordered fields (mobilePhoneNumber1, mobilePhoneNumber2) in the form's own left-to-right column order.

• mobilePhoneNumber2 string optional

  A second mobile phone number, printed by the form as an identically-labelled second "Mobile No." column (see mobilePhoneNumber1).

• emailAddress1 string optional

  Applicant's email address. The source form prints two identically-labelled "E-mail" / "כתובת אלקטרונית" boxes with no distinguishing sub-label; modelled as two generically-ordered fields (emailAddress1, emailAddress2) in the form's own left-to-right column order.

  pattern
• emailAddress2 string optional

  A second email address, printed by the form as an identically-labelled second "E-mail" box (see emailAddress1).

  pattern
• purposeOfVisit string required

  The applicant's stated purpose for travelling to Israel.

• addressInIsrael string required

  The address in Israel where the applicant will be staying.

• expectedEntryDateAndPlaceInIsrael string required

  The applicant's expected date and place (border crossing/airport) of entry into Israel. The form prints date and place as a single combined column with no internal sub-division, modelled here as one free-text field.

• expectedDurationOfStay string required

  The applicant's expected duration of stay in Israel.

• transitCountries string optional

  Countries the applicant will transit through en route to Israel, if any.

• previousStaysInIsrael string optional

  Dates of the applicant's previous stays in Israel, if any. The form prints this as a three-blank-column area with no internal sub-headers; modelled as a single free-text field.

• residencePermitCategory enum required

  The category of residence permit or entry status requested. The form prints five categories across a two-column, three-row checkbox grid, each mirrored in a Hebrew-labelled and an English-labelled checkbox (see documentType for the same mirrored-checkbox convention); the two rightmost checkboxes in the top row correspond to "ביקור"/"Visitor", the two leftmost in the top row to "תושב"/"Resident", the second row's right checkbox to "ארעי" (glossed "Temporary Resident") and left checkbox to "עולה"/"Immigrant", and the third row's single checkbox to "עבודה"/"Work".

  enum: VISITOR | RESIDENT | TEMPORARY_RESIDENT | IMMIGRANT | WORK
• spouseFamilyName string optional

  Spouse's family name, if the applicant's spouse is included in this application.

• spouseGivenName string optional

  Spouse's given name.

• spouseMaidenName string optional

  Spouse's maiden name.

• spouseFathersName string optional

  Spouse's father's name.

• spousePlaceOfBirth string optional

  Spouse's place of birth.

• spouseDateOfBirth date optional

  Spouse's date of birth.

• child1GivenName string optional

  Given name of child under 18 #1 included in this application, if applicable. The form prints a fixed table of 6 numbered rows (not an open-ended repeating group); GovSchema's repeating-groups proposal (GSP-0009) is not yet part of the accepted v0.3 specification, so each of the form's own 6 rows is modelled as its own bounded field set, following this registry's established bounded-repeating-group convention.

• child1PlaceOfBirth string optional

  Place of birth of child under 18 #1.

• child1DateOfBirth date optional

  Date of birth of child under 18 #1.

• child2GivenName string optional

  Given name of child under 18 #2 included in this application, if applicable. The form prints a fixed table of 6 numbered rows (not an open-ended repeating group); GovSchema's repeating-groups proposal (GSP-0009) is not yet part of the accepted v0.3 specification, so each of the form's own 6 rows is modelled as its own bounded field set, following this registry's established bounded-repeating-group convention.

• child2PlaceOfBirth string optional

  Place of birth of child under 18 #2.

• child2DateOfBirth date optional

  Date of birth of child under 18 #2.

• child3GivenName string optional

  Given name of child under 18 #3 included in this application, if applicable. The form prints a fixed table of 6 numbered rows (not an open-ended repeating group); GovSchema's repeating-groups proposal (GSP-0009) is not yet part of the accepted v0.3 specification, so each of the form's own 6 rows is modelled as its own bounded field set, following this registry's established bounded-repeating-group convention.

• child3PlaceOfBirth string optional

  Place of birth of child under 18 #3.

• child3DateOfBirth date optional

  Date of birth of child under 18 #3.

• child4GivenName string optional

  Given name of child under 18 #4 included in this application, if applicable. The form prints a fixed table of 6 numbered rows (not an open-ended repeating group); GovSchema's repeating-groups proposal (GSP-0009) is not yet part of the accepted v0.3 specification, so each of the form's own 6 rows is modelled as its own bounded field set, following this registry's established bounded-repeating-group convention.

• child4PlaceOfBirth string optional

  Place of birth of child under 18 #4.

• child4DateOfBirth date optional

  Date of birth of child under 18 #4.

• child5GivenName string optional

  Given name of child under 18 #5 included in this application, if applicable. The form prints a fixed table of 6 numbered rows (not an open-ended repeating group); GovSchema's repeating-groups proposal (GSP-0009) is not yet part of the accepted v0.3 specification, so each of the form's own 6 rows is modelled as its own bounded field set, following this registry's established bounded-repeating-group convention.

• child5PlaceOfBirth string optional

  Place of birth of child under 18 #5.

• child5DateOfBirth date optional

  Date of birth of child under 18 #5.

• child6GivenName string optional

  Given name of child under 18 #6 included in this application, if applicable. The form prints a fixed table of 6 numbered rows (not an open-ended repeating group); GovSchema's repeating-groups proposal (GSP-0009) is not yet part of the accepted v0.3 specification, so each of the form's own 6 rows is modelled as its own bounded field set, following this registry's established bounded-repeating-group convention.

• child6PlaceOfBirth string optional

  Place of birth of child under 18 #6.

• child6DateOfBirth date optional

  Date of birth of child under 18 #6.

• contact1Name string optional

  Name of family member/acquaintance in Israel #1, if applicable. The form prints a fixed table of 4 numbered rows (not an open-ended repeating group); modelled as a bounded field set per row, following the same convention as the children table above.

• contact1Relation string optional

  Relation of family member/acquaintance in Israel #1 to the applicant.

• contact1Address string optional

  Address of family member/acquaintance in Israel #1.

• contact2Name string optional

  Name of family member/acquaintance in Israel #2, if applicable. The form prints a fixed table of 4 numbered rows (not an open-ended repeating group); modelled as a bounded field set per row, following the same convention as the children table above.

• contact2Relation string optional

  Relation of family member/acquaintance in Israel #2 to the applicant.

• contact2Address string optional

  Address of family member/acquaintance in Israel #2.

• contact3Name string optional

  Name of family member/acquaintance in Israel #3, if applicable. The form prints a fixed table of 4 numbered rows (not an open-ended repeating group); modelled as a bounded field set per row, following the same convention as the children table above.

• contact3Relation string optional

  Relation of family member/acquaintance in Israel #3 to the applicant.

• contact3Address string optional

  Address of family member/acquaintance in Israel #3.

• contact4Name string optional

  Name of family member/acquaintance in Israel #4, if applicable. The form prints a fixed table of 4 numbered rows (not an open-ended repeating group); modelled as a bounded field set per row, following the same convention as the children table above.

• contact4Relation string optional

  Relation of family member/acquaintance in Israel #4 to the applicant.

• contact4Address string optional

  Address of family member/acquaintance in Israel #4.

• applicantNameAtSignature string required

  The applicant's name as re-printed in the form's own signature block, distinct from the familyName/givenName fields captured on page 1.

• applicationPlace string required

  The place where the application was signed.

• applicationDate date required

  The date the application was signed.