eVisa Online - ELECTRONIC VISA

Enter your Family (last) name as it appears in your passport in the Last name field. Last name is required to complete the application.

Family Name *

Enter your first name here as it appears in your passport in the First Name field. The first name is required to complete the application.

First (Given) Name *

Please indicate your gender. Required to complete the application.

Gender *

Enter the email address at which you can be contacted. The email address is required to complete the request. If you don't have an e-mail address, you may provide the e-mail address of a third party (for example, a family member, friend or colleague).

Email address *

Confirm here the email address you entered in the first Email field

Email confirmation *

Indicate your date of birth. Date of birth is required to complete the request.

Date of birth *

Choose the country where you were born. Country of birth is required to complete the request.

Country of birth *

Address

In this Line 1 Address field, enter your home address number and street. Don't include city and state in this field. Line 1 address is required to complete the application.

Address line 1 *

Enter the postal code of your city

Postcode *

Indicate here the city, the chief town, the village or the hamlet. The city, town, village or hamlet is required to complete the application.

Town or city *

Indicate your country of residence. The country is required to complete the application.

Country *

Please enter the requested information

State/province/region

At least one telephone number is required to complete the application. If you don't have a telephone number, you can give an alternative telephone number of a third party belonging to a contact point (for example a family member, friend or colleague). The telephone number is required to complete the application.

Mobile phone *

Passport information

Enter your passport number as it appears on your passport. The passport number may contain numbers and/or letters (9 maximum). Make a clear distinction between the number 0 and the letter O. The passport number is required to complete the application.

Passport Number *

Indicate the date your passport was issued, as it appears in your passport in the Date of Issue field. The date of issue of the passport is required to complete the application.

Date of issue *

Indicate the expiry date of your passport, as it appears in your passport in the Expiry Date field. The expiry date of the passport is required to complete the application.

Expiration date *

Choose the country of which you are a national, as it appears in your passport. The country of which you are a national is required to complete the application.

Citizenship *

Travel Information

Please select the port of Entry

Port of Entry in Cambodia *

Enter the address of your intended residence at the time of your visit

Address during Visit

Indicate your intended date of travel (Optional information)

Date of departure *

Kindly upload your scanned colored passport (Information page) in clear and sharp colours in one of the following formats: jpg, jpeg, gif, pdf

Passport (Bio-Information Page) *

Kindly upload your scanned ID photo in clear colour (white background) in one of the following formats: jpg, jpeg, gif, pdf. The photo must be less than 6 months old

Recent Passport-size Photo *

You must accept our general conditions of sale to continue

I accept the general conditions of sale

General information

Family Name :
First (Given) Name :
Gender :
Email address :
Email confirmation :
Date of birth :
Country of birth :
Address line 1 :
Postcode :
Town or city :
Country :
State/province/region :
Mobile phone :
Passport Number :
Date of issue :
Expiration date :
Citizenship :

Specific information

Port of Entry in Cambodia :
Address during Visit :
Date of departure :
Passport (Bio-Information Page) :
Recent Passport-size Photo :

I fully accept the terms and conditions.
I certify the accuracy of all the information provided on this e-Visa application, any error or omission may result in the rejection of my application.
I take note that any false statement will automatically result in the cancellation of my e-Visa application without any possibility of refund.
I accept that in the case of services immediately executed after my order, the 14-day right of withdrawal does not apply.
In case of cancellation request before processing, my order will be refunded except for the processing fee.

e-Visa Cambodia - Electronic visa for travel authorization

Form to complete to obtain, your e-Visa - Authorization required to visit Cambodia !

Form to complete to get eVisa Cambodia

Please enter the name, first name (s) and passport number exactly as they appear on your passport information page.

Address

Passport information

Travel Information

General information

Specific information