Last Name: (required)

Email: (required)

Phone: (required)

Nationality:

Age:
less than 1212-1819-23Over 23

How long are you planning to stay in Costa Rica?
less than 3 months3-6 months6-12 monts1-2 yearsover 2 years

Are you planning to invest money in Costa Rica?
YesNo

Are you planning to receive a stable monthly income in Costa Rica?
YesNo

Will you be employed by a Costa Rican Company?
YesNo

Are you related or married to a Costa Rican national?
YesNo

If your answer was YES, detail your relationship with the Costa Rican:

Have you ever filed an application for a legal status before Costa Rican Immigration Authorities? If so, please provide information:

Are you in Costa Rica right now?
YesNo