The Embassy of the Islamic Republic of Mauritania in Brussels

Registration form

Family name

First name

Date of birth

Place of birth

Sex

Female Male

Marital status

Profession

Addional information

Street

House number

Postal code

City

Country

E-mail

Address and phone number in Mauritania

Whom to contact in Mauritanian in case of an emergency

A copy of the passport or national identity card

Residence certificate

A recent photograph

The Embassy of the Islamic Republic of Mauritania in Brussels

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