韓國簽證申請表(單次填寫)

■出入境管理法實(shí)行規(guī)則[第17號(hào)樣式]簽證發(fā)給申請表APPLICATIONFORVISA<申請表填寫方法>?申請人須以事實(shí)為根據(jù)，并將在以下空格處完整記載。?申請人必須用中文或英文填寫以下申請表。?在相關(guān)選項(xiàng)的“[]”內(nèi)打鉤。?如您選擇“其他”，請寫具體內(nèi)容。<Howtofilloutthisform>?Youmustfilloutthisformcompletelyandcorrectly.?YoumustwriteinblockletterseitherinEnglishorKorean.?Formultiple-choicequestions,youmustcheck[√]allthatapply.?Ifyouselect‘Other’,pleaseprovideuswithmoreinformationinthegivenspace.1.個(gè)人信息/PERSONALDETAILSPHOTO護(hù)照規(guī)格照片(35㎜×45㎜)6個(gè)月內(nèi)拍攝的正面免冠彩色相片，相片背景顏色須為純白色Acolorphototakenwithinlast6months(fullfacewithouthat,frontviewagainstwhiteoroff-whitebackground)1.1護(hù)照上的英文姓名/FullnameinEnglish(asshowninyourpassport)姓FamilyNameCAO名GivenNamesLU1.2中文姓名漢字姓名曹璐1.3性別Sex男/Male[]女/Female[√]1.4出生日期DateofBirth(yyyy/mm/dd)1990/10/181.5國籍Nationality中國1.6出生國CountryofBirth中國1.7身份證號(hào)碼NationalIdentityNo.3508021990101815281.8過去訪韓時(shí)是否使用過其他姓名HaveyoueverusedanyothernamestoenterordepartKorea?否No[√]是Yes[]→選擇‘是’選項(xiàng)時(shí)填寫詳細(xì)內(nèi)容。If‘Yes’pleaseprovidedetails(姓FamilyName名GivenName)1.9是否雙重國籍Areyouacitizenofmorethanonecountry?否No[√]是Yes[]→選擇‘是’選項(xiàng)時(shí)記載詳細(xì)內(nèi)容。If‘Yes’pleasewritethecountries()領(lǐng)館審核欄FOROFFICIALUSEONLY????????????30D????????S?D?M????????????????????????????????????[]?[]????><郵票粘貼處><???????>B/L:?????:??????:???:????:??:2.簽證發(fā)給認(rèn)定書簽發(fā)信息（反簽號(hào)）/DETAILSOFVISAISSUANCECONFIRMATION※僅限于在大韓民國出入國管理事務(wù)所·辦事處收到簽證發(fā)給認(rèn)定書的人(Section2isonlyforthosewhopossessconfirmationofvisaissuanceissuedbytheImmigrationOfficeoftheRepublicofKorea)2.1簽證發(fā)給認(rèn)定號(hào)碼(反簽號(hào))ConfirmationNo.2.2簽發(fā)日期IssueDate2.3護(hù)照號(hào)碼PassportNo.2.4護(hù)照有效期PassportExpiryDate?簽證發(fā)給認(rèn)定書持有者直接移到第12部分(誓約)，填寫以下空格后提交申請表(不用寫第3~11部分)Thosewhohaveconfirmationofvisaissuancemustmovetosection12(Declaration)tocompletethisfrom(Thosewithvisaissuanceconfirmationmustnotfilloutsection3~11).3.護(hù)照信息/PASSPORTINFORMATION3.1護(hù)照種類PassportType外交Diplomatic[]公務(wù)Official[]公務(wù)普通Official[]因私Regular[√]其他Other[]→如您選擇‘其他’，請寫具體內(nèi)容If‘Other’pleaseprovidedetails()3.2護(hù)照號(hào)碼PassportNo.G567581233.3簽發(fā)國家CountryofPassport中國3.4簽發(fā)地點(diǎn)PlaceofIssue福建3.5簽發(fā)日期DateofIssue2011/12/133.6有效期間DateOfExpiry2021/12/123.7是否持有其他護(hù)照Doyouhaveanyothervalidpassport?否No[√]是Yes[]→如您選擇‘是’，請寫具體內(nèi)容If‘Yes’pleaseprovidedetailsa)護(hù)照種類PassportType外交Diplomatic[]公務(wù)Official[]公務(wù)普通Official[]因私Regular[√]其他Other[]b)護(hù)照號(hào)碼PassportNo.c)簽發(fā)國家CountryofPassportd)有效期間DateOfExpiry4.聯(lián)系方式/CONTACTINFORMATION4.1本國地址AddressinYourHomeCountry上海市浦東新區(qū)海陽路1080號(hào)香樟苑14座402室4.1現(xiàn)居住地CurrentResidentialAddress*僅限于現(xiàn)居住地與本國地址不同者/Writeifitisdifferentfromtheaboveaddress4.3手機(jī)號(hào)碼CellPhoneNo.132626776604.4固定電話TelephoneNo.021-508312094.5電子郵箱E-mailamydew1@163.com4.6緊急情況聯(lián)系人信息EmergencyContactInformationa)姓名FullName張瓊仙b)居住國家Countryofresidence中國c)電話號(hào)碼TelephoneNo)關(guān)系Relationshiptoyou母女5.婚姻狀況/MARITALSTATUSDETAILS5.1婚姻狀況CurrentMaritalStatus已婚Married[]離婚Divorced[]未婚Single[√]喪偶Widowed[]5.2配偶個(gè)人信息*標(biāo)記為已婚時(shí)填寫If‘Married’pleaseprovidedetailsofyourspousea)姓FamilyName(inEnglish)b)名GivenNames(inEnglish)c)出生日期DateofBirth(yyyy/mm/dd)d)國籍Nationalitye)住址ResidentialAddressf)聯(lián)系電話ContactNo.6.學(xué)歷/EDUCATION國家NameofCountry訪問目的PurposeofVisit訪問期間PeriodofStay(yyyy/mm/dd)~(yyyy/mm/dd)美國攻讀碩士2013.7.25-2014.9.22泰國旅游2015.12.31-20.同行家屬AreyoutravellingtoKoreawithanyfamilymember?無No[√]有Yes[]→如您選擇“有”，請寫具體內(nèi)容If‘Yes’pleaseprovidedetailsofthefamilymembersyouaretravellingwith姓名FullnameinEnglish出生日期DateofBirth(yyyy/mm/dd)國籍Nationality關(guān)系Relationshiptoyou*參考:家屬范圍–配偶,子女,父母,兄弟姐妹Note:DefinitionofaFamilyMember-yourspouse,father,mother,children,brothersandsisters10.訪問經(jīng)費(fèi)/FUNDINGDETAILS10.1訪問經(jīng)費(fèi)(美元為基準(zhǔn))Estimatedtravelcosts(inUSdollars)2000美元10.2訪韓費(fèi)用支付者Whowillpayforyourtravel-relatedexpenses?(anypersonincludingyourselfand/orinstitute)a)姓名/單位名稱NameofPerson/Company(Institute)本人b)關(guān)系Relationshiptoyouc)支援內(nèi)容TypeofSupportd)聯(lián)系電話ContactNo.11.填寫申請表時(shí)是否接受過幫助/ASSISTANCEWITHTHISFORM11.1您在填寫申請表時(shí)是否接受過別人的幫助？Didyoureceiveassistanceincompletingthisform?否[√]No是Yes[]→如您選擇“是”，請寫具體內(nèi)容If‘Yes’pleaseprovidedetailsofthepersonwhoassistedyou姓名FullName出生日期DateofBirth(yyyy/mm/dd)聯(lián)系電話TelephoneNo.關(guān)系Relationshiptoyou12.誓約/DECLARATION*簽證發(fā)給認(rèn)定書持有者也須填寫Thosewhopossessconfirmationofvisaissuancemustonlycompletesection1,2,and12ofthisform根據(jù)本人所知所信，我聲明以上所有陳述均真實(shí)、準(zhǔn)確、完整。我將遵守大韓民國的出入境管理法律法規(guī)。Ideclarethatthestatementsmadeinthisapplicationaretrueandcorrecttothebestofmyknowledgeandbelief,andthatIwillcomplywiththeImmigrationActoftheRepublicof申請日期(年.月.日)DATEOFAPPLICATION(yyyy/mm/dd)???申請人（簽名）SIGNATUREOFAPPLICANT申請人未滿17歲，父母或法定監(jiān)護(hù)人簽名SignatureofParentorLegalGuardian′sforapersonunder17yearsofage附件ATTACHMENT1.「出入境管理法實(shí)行規(guī)則」第76條第1項(xiàng)[表格5]簽證發(fā)給申請等附件注意事項(xiàng)Notice1.有關(guān)上述事項(xiàng)，本表如不夠填寫可另加附頁或是追加提供相關(guān)材料。Ifextraspaceisneededtocompleteanyitem,recordonaseparatesheetofpaperorsubmitrelevantdocumentswhichcouldsupportyourapplication.2.如您的大韓民國簽證得到批準(zhǔn)后因遺失、損毀等原因再次簽發(fā)，必須通知簽證處理機(jī)構(gòu)變更的護(hù)照信息，以便準(zhǔn)確反映個(gè)人信息。IfyoureceivedKoreanvisaapproval,andhavenewpassportissuedthereafterinlieuoflost/damagedpassport,youmustnotifythec