Application form

Family Name/s

First Name/s

Date of Birth (DD/MM/YYYY)

Gender Male Female

Place of Birth

Citizenship

Address in Hungary

Telephone

Immigration status in Hungary

Irregular migrant

Asylum application pending

Asylum application withdrawn

Asylum application rejected

Other, not categorized in this list:

Other immigration status

Do you have any special needs for travel (medication, escort, wheelchair, etc.)?

...to transit through an airport? Yes No

...at airport upon return? Yes No

...to travel home from airport? Yes No

Name of settlement:

Address in country of origin (please state full address)

E-mail

Telephone

Other information source

Security check

Thank you!