1. 姓Surname                                      汉字姓名

2. 名 Given Names   

3. 生年月日 Date of Birth

4. 性别 Sex

o M   o F

5. 国籍Nationality

6. 出生地 Place of Birth

7. 护照号码

Passport Number

8. 种类 Classification

外交Ÿ 因公Ÿ 因私Ÿ 其他

DP   OF   OR

9. 签发日

Date of Issue

10.签发地

Place of Issue

11. 发给机关

Issuing Authority

12. 到期日

Expiry Date

13. 结婚与否 Marital Status

已婚married     o 未婚single

14. 配偶者姓名Spouse’s Name

15. 配偶者国籍 Spouse’s Nationality

16.职业Occupation

17. 单位名与住所 Name and Address of Present Employer

18. 单位电话号Business Phone Number

19. 入国目的 Purpose of Entry

20. 入国预定日 Probable Date of Entry

21.预定滞留期间 Desired Length of Stay

22. 现住所Home Address                                             电话号码 Phone No.

23. 韩国滞留地  Address in Korea             电话号码  Phone No.

24. 访韩事实 Previous Visit (If Any)

25. 过去是否得到过签证  Have You Ever Been Issued a Korean Visa ?                        o Yes         □No

何时When ?                        何地 Where ?                      签证种类 What Type of Visa ?

26. 过去是否被拒签过   Have You Ever Been Refused a Korean Visa ?                        o Yes         □No

   何时When ?                        何地 Where ?                      签证种类 What Type of Visa ?

27. 旅行费用支付者 Who Will Pay For Your Trip ?

28. 过去是否取消过签证

Has Your Korean Visa Ever Been Cancelled or Revoked ?

o Yes                □No

29. 最近5年间旅行过的国家 Countries Where You Have Lived or Traveled During The Past 5 Years

30. 同伴家族

Accompanying Family

国籍Nationality

姓名 Name

性别 Sex

生年月日 Date of Birth

31. 韩国担保人联络处

Guarantor or Reference in Korea

姓名 Name

住所 Address

电话号码 Phone No.

关系 Relationship

I declare that the statements made in this application are true and correct to the best of my knowledge and belief, that I will observe the provisions of the Immigration Law of the Republic of Korea and that I will not engage in any activities irrelevant to the purpose of entry stated herein Besides, I am fully aware that any false or misleading statement may result in the refusal of all visa, and that possession of a visa does not entitle the bearer to enter the Republic of Korea upon arrival at the port of entry if he/she is found inadmissible.

申请日DATE OF APPLICATION                  申请人署名 SIGNATURE OF APPLICANT

공    용    란    FOR OFFICIAL USE ONLY

접수번호

접수일시

결 재

승인번호

처리과

사증종류

복수/단수

담당자

체류자격

체류기간

고지사항