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Sri Lanka on-line appliaction

Data Set
Mercury Holidays
Mercury Holidays Booking Reference Number
Applicant Details
Passport Number*
Nationality*
Date of Birth*
Date Format: DD slash MM slash YYYY
Gender*
- Male
- Female
Country of Birth*
Passport Issue Date*

DD
MM
YYYY
Passport Expiry Date*

DD
MM
YYYY
Passport Issue Authority (i.e UKPA)*
Title
Surname (as shown in passport)*
Given Name(s) (as shown in passport)*
Are you also applying for a child (under 12)?*
Children under the age of 12 can obtain a Sri Lanka ETA for free. Those aged over 12 will need to make an individual application. If you need to make an application for multiple children, please contact us on 01270 904 907.
- No
- Yes
Child's Date of Birth*
Date Format: DD slash MM slash YYYY
Child's Gender*
- Male
- Female
Child's Surname (as shown in passport)*
Child's Given Names*

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Travel Details
Date of Travel*

DD
MM
YYYY
Length of Stay*
Please enter a number from 0 to 90.
Purpose of Visit*
Flight Number*
Port of Departure*
Airline*
Address whilst in Sri Lanka (if known)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

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Contact Details
Mobile Phone Number
Daytime Phone Number*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Enter Email Confirm Email

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Price Breakdown.

Visa Type	Priority	Processing Time	Embassy Fee	Service Fee	VAT	Total
Double Entry	1	72 hours*	£33.00	£39.13	£7.83	£79.95
Double Entry	2	5 days*	£33.00	£19.96	£3.99	£56.95
Transit	2	5 days*	£0.00	£24.13	£4.83	£28.95

*Working days/hours excluding postal days.

Sri Lanka ETA*
Price: £ 56.95
Processing time*
*Working days/hours excluding postal days.
How would you like to receive confirmation?*
Total
£ 0.00
Payment Details
Credit/Debit Card*

Card Details

Cardholder Name
Billing Address*
Same as previous

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Total
£ 0.00
Important
Please tick to confirm you you have read, fully understood and agree to the following:*
- I, the applicant, hereby certify that I have read, or have had read to me, all the questions and statements on this application and understand all the questions and statements on this application. The answers and information furnished in this application are true and correct to the best of my knowledge and belief.
Terms and Conditions*
http://thetravelvisacompany.co.uk/terms/tvcterms.pdf
http://thetravelvisacompany.co.uk/declaration
- I have read, fully understood and agree to the Terms & Conditions and Client Declaration

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Mercury Holidays