大溪地表格签署（此页不用打印,打印第二页签字就可以）.docVIP

大溪地表格签署（此页不用打印，打印第二页签字就可以） 请在第二页表格第37项和表格最后一行签名（需本人签名且尽量与护照上签名保持一致，不能代签，不能涂改。） 34. Personal data of the family member who is an EU, EEA or CH citizen 家庭成员为欧盟、欧洲经济区或瑞士公民，请填上其个人资料 Surname 姓氏 Date of birth / 出生日期 Nationality / 国籍 First name(s) 名字 Number of travel document or ID card 旅行证件或身分证编号 35. Family relationship with an EU, EEA or CH citizen 申请人与欧盟、欧洲经济区或瑞士公民的关系 ?spouse 配偶 ?child …….………………………. 子女 ?grandchild 孙儿女 ?dependent ascendant 受养人 36. Place and date / 地区 及 日期 37. Signature (for minors, signature of parental authority/legal guardian) 签署（未成年人由其监护人代签） I am aware that the visa fee is not refunded if the visa is refused / 本人知道即使签证被拒也不能退还签证费 Applicable in case a multiple-entry visa is applied for (cf. field No24): / 适用于申请多次入境签证 (参照字段 24) I am aware of the need to have an adequate travel medical insurance for my first stay and any subsequent visits to the territory of 本人知道须预备有足够保额的旅游医疗保险作为首次及其后各次出发到申根国家领域之用 I am aware of and consent to the following: the collection of the data required by this application form and the taking of my photograph and, if applicable, the taking of fingerprints, are mandatory for the examination of the visa application; and any personal data concerning me which appear on the visa application form, as well as my fingerprints and my photograph will be supplied to the relevant authorities of the Member States and processed by those authorities, for the purposes of a decision on my visa application. Such data as well as data concerning the decision taken on my application or a decision whether to annul, revoke or extend a visa issued will be entered into, and stored in the Visa Information System (VIS) (1) for a maximum period of five years, during which it will be accessible to the visa authorities and the authorities competent for carrying out checks on visas at external borders and within the Member States, immigration and asylum authorities in the Member States for the purposes of verifying whether the conditions for the leg