越南落地签空白表格.doc

.nh photo4x6 cmSee notes(2)T KHAI NGH CP TH THC VIT NAM (1)VIETNAMESE VISA APPLICATION FORM(Dng cho ngi nc ngoi For foreigners)1- H tn (ch in hoa) : . Full name (in capital letters)2- Gii tnh: NamN3- Sinh ngy . thng . nm .Sex Male Female Date of birth (day, month, year)4- Ni sinh : . Place of birth5- Quc tch gc : . 6- Quc tch hin nay:. Nationality at birth Current nationality7- Tn gio: . 8- Ngh nghip: . ReligionOccupation9- Ni lm vic : . Employer and business address10- a ch thng tr: .Permanent residential address.S in thoi/Email: . Telephone/Email11- Thn nhn (Family members):Quan hRelationshipH tn (ch in hoa)Full name(in capital letters)Gii tnhSexNgy sinhDate of birth(Day, Month, Year)Quc tchNationalitya ch thng trPermanent residential address12- H chiu s/ giy t c gi tr thay h chiu s: .loi (4): . Passport or International Travel Document number C quan cp: . c gi tr n ngy ././. Issuing authority: Expiry date (day, month, year) 13- Ngy nhp xut cnh Vit Nam gn nht (nu c): . Date of previous entry into Viet Nam (if any)14- D kin nhp cnh Vit Nam ngy ././.; tm tr Vit Nam .ngy Intended date of entry (Day, Month, Year) Intended length of stay in Viet Nam: days15- Mc ch nhp cnh: . Purpose of entry 16- D kin a ch tm tr Viet Nam:.Intended temporary residential address in Viet Nam17- C quan, t chc hoc c nhn ti Vit Nam mi, bo lnh: Hosting organisation/ individual in Viet Nam - C quan, t chc: . Name of hosting organizationa ch: . Address - C nhn: (h tn) . Hosting individual (full name) a ch. Address Quan h vi bn thn . Relationship to the applicant18- Tr em di 14 tui i cng h chiu (nu c): Accompanying child(ren) under 14 years old included in your passport (if any)nh photo4x6 cmSee notes(2)nh photo4x6 cmSee notes(2)S TTNoH tn (chu in hoa)Full name(in capital letters)Gii tnh(sex)Ngy thng nm sinhDate of birth19- ngh cp th thc: mt ln nhiu lnApplying for a visa Single MultipleT ngy:././.n ngy:././.Valid from (Day, Month, Year) to (Day, Month, Year) 20- ngh khc lin quan vic cp th thc (nu c):.Other requests (if any). Ti xin cam oan nhng ni dung trn y l ng s tht. I declare to the best of any knowledge that all the above particular are corect.Lm ti: . ngy . thng .nm .Done at date (Day, Month, Year)Ngi ngh (k, ghi r h tn)The applicants signature and full name Ghi ch/Notes:(1) Mi ngi khai 01 bn km theo h chiu hoc giy t i li quc t, np trc tip ti c quan i din Vit Nam nc ngoi hoc n v kim sot xut nhp cnh ti ca khu quc t ni nhn th thc.Submit in person one completed application form enclosed with passport or International Travel Document at the Vietnamese Diplomatic Mission abroad or at the international border checkpoint immigration office where the visa is issued.(2) Km 02 nh mi chp, c 4 x 6 cm, phng nn trng, mt nhn thng, u trn, khng eo knh mu (01 nh dn vo t khai, 01 nh ri).Enclose 2 recently taken photos in 4x6cm size, with white background, front view, bare head, without sunglasses (one of the form and the other separate) (3) Ghi r b, m, v, chng, con, anh, ch, em rut (nu c).State clearly the information about parents, spouse, children and siblings (if any).(4) Ghi r loi h chiu ph thng, cng v, ngoi