THE REPUBLIC OF VANUATU.doc

THE REPUBLIC OF VANUATU APPLICATION FOR A VISA FOR VANUATU Attach 1 passport size photograph 请附1张护照照片 瓦努阿图共和国签证申请表 1 Full name 姓名:（English 英文）……………………….. (Chinese 中文)………………………. 2 Mr.先生□ / Mrs.女士□ /Miss小姐□ 3 Nationality 国籍:…………………………. 4 Date of Birth出生日期: Day日…………….. /Month月……………….. /Year年…………….. 5 Place of birth 出生地点:…………………………………………. 6 Family Situation婚姻状况: Married已婚□Single单身□Widowed丧偶□Divorced离异□ 7 Occupation 职业:…………………… 8 (a) Employer 就业单位:………………………………………Tel No.电话:……………………. (b) Address 单位地址:……………………………………………………………………………. 9 Home Address 家庭住址：……………………………………………………………………… ……………………………………………………..Tel No. 电话:……………………………….. 10 Passport 护照 (a) Number 护照号……………………（b） Place of Issue 发照地…………………………….. (c)Date of Issue发照日期…………….. （d） Expiry Date 有效日期至……… ………………. 11 Purpose of Visit: 访瓦目的 Tourism旅游□ Visiting Relative探亲□ Business商务□ Other 其他□ 12 Address in Vanuatu 在瓦地址：………………………………………………………………… 13 Details of Family in Vanuatu if visiting relative如属探亲在瓦亲属概况： Name 姓名：…………………… Add. 地址:………………………………………………….. 14 Details of arrival in Vanuatu抵瓦航班号:………………….…日期:…………………………… 15 Details of return ticket 回程航班号:……………………日期:………………………………… 16 Proposed duration of stay 拟在瓦逗留时间：…………………………………………………. 17 Source of financial support in Vanuatu在瓦费用来源:………………………………………… 18 Details of family included in passport： 护照内偕行儿童详细信息： Name 姓名 Sex 性别 Date of birth 出生日期 Place of birth 出生地 19（a）Been convicted of or have any charges outstanding on a criminal offence in any country 是否在任何国家有过犯罪记录: Yes是□ Where哪一国家………………………………No否□ (b) Been deported or excluded from any country 是否有被任何国家驱逐出境的经历: Yes是□ Where哪一国家……………………………………………………………No否□ 20 Details of previous visits? 您曾经到过瓦努阿图吗？Yes有□ No没有□ 21 Have you ever applied for a work, residence or student permit before in Vanuatu? 您是否曾经在瓦努阿图申请过工作、居留或学生签证？Yes是□When何时…………………… No否□ 22 Have you ever been refused entry to Vanuatu? 您曾经被瓦努阿图拒签过吗？ Yes是□When 何时………………