韓國簽證申請表(單次填寫).doc

出入境管理法 實(shí)行規(guī)則 第17號樣式簽證發(fā)給申請表APPLICATION FOR VISA 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。 You must fill out this form completely and correctly. You must write in block letters either in English or Korean. For multiple-choice questions, you must check all that apply. If you selectOther, please provide us with more information in the given space.1. 個人信息 / PERSONAL DETAILSPHOTO護(hù)照規(guī)格照片(3545)6個月內(nèi)拍攝的正面免冠彩色相片，相片背景顏色須為純白色A color photo taken within last 6 months(full face withouthat, front view against white or off-white background)1.1 護(hù)照上的英文姓名/Full name in English (as shown in your passport)姓 Family Name CAO名 Given NamesLU1.2 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 Date of Birth (yyyy/mm/dd)1990/10/181.5 國籍 Nationality中國1.6 出生國 Country of Birth中國1.7 身份證號碼 National Identity No.3508021990101815281.8 過去訪韓時是否使用過其他姓名Have you ever used any other names to enter or depart Korea? 否 No 是 Yes 選擇是選項(xiàng)時填寫詳細(xì)內(nèi)容。 IfYesplease provide details (姓 Family Name 名 GivenName )1.9 是否雙重國籍 Are you a citizen of more than one country ? 否 No 是 Yes 選擇是選項(xiàng)時記載詳細(xì)內(nèi)容。 IfYesplease write the countries ( )領(lǐng)館審核欄 FOR OFFICIAL USE ONLY30DS D M B/L:2. 簽證發(fā)給認(rèn)定書簽發(fā)信息（反簽號） / DETAILS OF VISA ISSUANCE CONFIRMATION 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(Section 2 is only for those who possess confirmation of visa issuance issued by the Immigration Office of the Republic of Korea)2.1 簽證發(fā)給認(rèn)定號碼(反簽號)Confirmation No.2.2 簽發(fā)日期 Issue Date2.3 護(hù)照號碼 Passport No.2.4 護(hù)照有效期Passport Expiry Date 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311部分)Those who have confirmation of visa issuance must move to section 12 (Declaration) to complete this from (Thosewith visa issuance confirmation must not fill out section 311).3. 護(hù)照信息 / PASSPORT INFORMATION3.1 護(hù)照種類Passport Type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 IfOtherplease provide details ( )3.2 護(hù)照號碼 Passport No. G567581233.3簽發(fā)國家 Country of Passport中國3.4 簽發(fā)地點(diǎn) Place of Issue福建3.5 簽發(fā)日期 Date of Issue 2011/12/133.6 有效期間 Date Of Expiry2021/12/123.7 是否持有其他護(hù)照 Do you have any other valid passport ? 否 No 是 Yes 如您選擇是，請寫具體內(nèi)容 IfYesplease provide detailsa) 護(hù)照種類Passport Type外交 Diplomatic 公務(wù) Official 公務(wù)普通 Official 因私 Regular 其他 Other b) 護(hù)照號碼 Passport No. c) 簽發(fā)國家 Country of Passportd) 有效期間 Date Of Expiry4. 聯(lián)系方式 / CONTACT INFORMATION4.1 本國地址 Address in Your Home Country 上海市浦東新區(qū)海陽路1080號香樟苑14座402室4.1 現(xiàn)居住地 Current Residential Address *僅限于現(xiàn)居住地與本國地址不同者 / Write if it is different from the above address4.3 手機(jī)號碼 Cell Phone No. 132626776604.4 固定電話 Telephone No.021-508312094.5 電子郵箱 E-4.6 緊急情況聯(lián)系人信息 Emergency Contact Information a) 姓名 Full Name 張瓊仙b) 居住國家 Country of residence 中國c) 電話號碼 Telephone No.) 關(guān)系 Relationship to you 母女5. 婚姻狀況 / MARITAL STATUS DETAILS5.1 婚姻狀況 Current Marital Status已婚 Married 離婚 Divorced 未婚 Single 喪偶Widowed 5.2 配偶個人信息 *標(biāo)記為已婚時填寫 IfMarriedplease provide details of your spousea) 姓 Family Name (in English) b) 名 Given Names (in English) c) 出生日期 Date of Birth (yyyy/mm/dd) d) 國籍 Nationality e) 住址 Residential Address f) 聯(lián)系電話 Contact No. 6. 學(xué)歷 / EDUCATION6.1 最終學(xué)歷 What is the highest degree or level of education you have completed ?碩士/博士 Masters/Doctoral Degree 學(xué)士 Bachelors Degree 高中 High School Diploma 其他 Other 如您選擇“其他”，請寫具體內(nèi)容 IfOtherplease provide details ( ) 6.2 學(xué)校名稱 Name of School 舊金山大學(xué)6.3 學(xué)校地址 Location of School(city/province/country)美國加州舊金山7. 職業(yè) / EMPLOYMENT7.1 職業(yè) What are your current personal circumstances ?企業(yè)家 Entrepreneur 個體經(jīng)營 Self-Employed 職員 Employed 公務(wù)員 Civil Servant 學(xué)生 Student 退休者 Retired 無職 Unemployed 其他 Other 如您選擇“其他”，請寫具體內(nèi)容 IfOtherplease provide details ( )7.2. 職業(yè)詳細(xì)信息 Employment Detailsa) 單位/機(jī)構(gòu)/學(xué)校（名稱） Name of Company/Institute/School 招商證券股份有限公司b) 職位/專業(yè) Your Position/Course財富顧問c) 單位/機(jī)構(gòu)/學(xué)校（地址） Address of Company/Institute/School 上海市浦東新區(qū)上南路3121號d) 電話號碼 Telephone No.132626776608. 邀請人信息 / DETAILS OF SPONSOR8.1 邀請人/邀請單位 Do you have anyone sponsoring you for the visa ?否 No 是 Yes 如您選擇“有”，請寫具體內(nèi)容 IfYesplease provide detailsa) 邀請人/邀請單位（名稱 ）Name of your visa sponsor (Korean, foreign resident in Korea, company, or institute)b) 出生日期/營業(yè)執(zhí)照號碼 Date of Birth/Business Registration No. b) 關(guān)系 Relationship to youd) 地址 Address e) 電話號碼 Phone No. 9. 訪問信息 / DETAILS OF VISIT9.1 赴韓目的 Purpose of Visit to Korea 觀光/經(jīng)由 Tourism/Transit 參加會議/Meeting, Conference 醫(yī)療觀光 Medical Tourism 短期商務(wù) Business Trip 留學(xué)/研修 Study/Training 就業(yè) Work 貿(mào)易/投資/派駐Trade/Investment/Intra-Corporate Transferee 探親Visiting Family/Relat ives/Friends 結(jié)婚移民 Marriage Migrant 外交/公務(wù) Diplomatic/Official 其他 Other 如您選擇“其他”，請寫具體內(nèi)容 IfOtherplease provide details ( )9.2 預(yù)定停留時間Intended Period of Stay7天9.3 訪韓預(yù)定日 Intended Date of Entry20 韓國聯(lián)系地址(包括酒店) Address in Korea(including hotels)9.5 韓國境內(nèi)聯(lián)系方式 Contact No. in Korea9.6 最近5年內(nèi)是否訪問過韓國 Have you travelled to Korea in the last 5 years ?否 No 是 Yes 如您選擇“是”，請寫具體內(nèi)容 IfYesplease provide details of any trips to Korea( ) 次 times, 最近訪韓目的 Purpose of Recent Visit ( )9.7 最近5年內(nèi)是否訪問過其他國家（韓國除外）Have you travelled outside your country of residence, excluding to Korea, in the last5 years ?否 No 是 Yes 如您選擇“是”，請寫具體內(nèi)容 IfYesplease provide details of these trips國家 Name of Country 訪問目的 Purpose of Visit訪問期間 Period of Stay(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 Are you travelling to Korea with any family member ?無 No 有 Yes 如您選擇“有”，請寫具體內(nèi)容 If Yes please provide details of the family members you are travelling with姓名 Full name in English出生日期 Date of Birth(yyyy/mm/dd)國籍Nationality關(guān)系 Relationship to you* 參考: 家屬范圍 配偶, 子女, 父母, 兄弟姐妹Note: Definition of a Family Member - your spouse, father, mother, children, brothers and sisters10. 訪問經(jīng)費(fèi) / FUNDING DETAILS10.1 訪問經(jīng)費(fèi)(美元為基準(zhǔn)) Estimated travel costs(in US dollars) 2000美元10.2 訪韓費(fèi)用支付者 Who will pay for your travel-related expenses ? (any person including yourself and/or institute)a) 姓名/單位名稱 Name of Person/Company(Institute) 本人b) 關(guān)系 Relationship to youc) 支援內(nèi)容 Type of Support d) 聯(lián)系電話 Contact No.11. 填寫申請表時是否接受過幫助 / ASSISTANCE WITH THIS FORM11.1 您在填寫申請表時是否接受過別人的幫助？Did you receive assistance in completing this form?否 No 是 Yes 如您選擇“是”，請寫具體內(nèi)容 IfYesplease provide details of the person who assisted you姓名 Full Name出生日期 Date of Birth(yyyy/mm/dd)聯(lián)系電話 Telephone No.關(guān)系Relationship to you12. 誓約 / DECLARATION* 簽證發(fā)給認(rèn)定書持有者也須填寫Those who possess confirmation of visa issuance must only complete section 1,2, and 12 of this form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)。I declare that the statements made in this application are true and correct to the best of my knowledge and belief,and that I will comply with the Immigration Act of the Republic of Korea.申請日期 (年. 月. 日) DATE OF APPLICATION (yyyy/mm/dd) 申請人（簽名） SIGNATURE OF APPLICANT申請人未滿17歲，父母或法定監(jiān)護(hù)人簽名Signature of Parent or Legal Guardians for a person under 17 years of age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。If extra space is needed to complete any item, record on a separate sheet of paper or submit relevant documents which couldsupport your application.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)確反映個人信息。If you received Korean visa approval, a