Name, last name (family name) *

Your father's name *

Your mother's name *

Date of birth *

Gender *

Male
Female

Status *

Single
Married
Widow
Divorced
Civil partner

Citizenship *

Occupation *

Country of birth *

City of birth *

Identification document *

Travel document
Regular passport
Diplomatic passport
Other

Number of document *

Country of issue *

Authority of issue *

Date of issue *

Date of expiry *

Contact information: residence address (street, zip code, city, country) *

Contact information: email, phone number *

Choose application request ground *

Work
Study
Family reunion

What are the application request ground? *

Employed
Self employed
Blue Card AL
Seasonal employed
Scientific research
Employed in state, humanitarian or religious institutions
Other nonprofit activities

Period of time for which the residence is requested *

3 months
6 months
12 months

When have you entered Albania? *

In which border crossing point have you entered Albania? *

Information about your working institution, name and address *

Fiscal code NUIS/ NIPT *

Host name if you have one *

Host institution *

Do you have a working permit? *

Yes
No
Have applied

Host contact number *

Do you have a sponsor or have your own monetary means? *

Have you ever been convicted of an offence and sentenced? If yes, specify *

Do you suffer of any illness? If yes specify *

Scanned copy of the passport

Scanned copy of photo (passport format)

Scanned copy of the Renting Contract or document of the residence address.

Scanned copy of the financial means from sponsor if you have one

Request Form

Fields marked with an * are required.