中国签证申请表

第1页共4页/Page1of4FormV.2013中华人民共和国签证VisaApplicationFormofthePeople’sRepublicofChina(FortheMainlandofChinaonly)申请人必须如实、完整、清楚地填写本表格。请逐项在空白处用中文或英文大写字母打印填写，或在□内打√选择。如有关项目不适用，请写“无”。Theapplicantshouldfillinthisformtruthfully，completelyandclearly.PleasetypetheanswerincapitalEnglishlettersinthespaceprovidedortick(√)therelevantboxtoselect.Ifsomeoftheitemsdonotapply,pleasetypeN/AorNone.一、个人信息Part1:PersonalInformation1.1英文姓名FullEnglishnameasinpassport姓Lastname粘贴一张近期正面免冠、浅色背景的彩色护照照片。照片/PhotoAffixonerecentcolorpassportphoto(fullface,frontview,bareheadedandagainstaplainlightcoloredbackground).中间名Middlename名Firstname1.2中文姓名NameinChinese1.3别名或曾用名Othername(s)1.4性别Sex□男M□女F1.5出生日期DOB(yyyy-mm-dd)1.6现有国籍Currentnationality(ies)1.7曾有国籍Formernationality(ies)1.8出生地点(市、省/州、国)Placeofbirth(city,province/state,country)1.9身份证/公民证号码LocalID/Citizenshipnumber1.10护照/旅行证件种类Passport/Traveldocumenttype□外交Diplomatic□公务、官员ServiceorOfficial□普通Ordinary□其他证件(请说明)Other(Pleasespecify):1.11护照号码Passportnumber1.12签发日期Dateofissue(yyyy-mm-dd)1.13签发地点Placeofissue1.14失效日期Dateofexpiry(yyyy-mm-dd)1.15当前职业（可选多项）Currentoccupation(s)□商人Businessperson□公司职员Companyemployee□演艺人员Entertainer□工人/农民Industrial/Agriculturalworker□学生Student□乘务人员Crewmember□自雇Self-employed□无业Unemployed□退休Retired□前/现任议员Former/incumbentmemberofparliament职位Position________________________□前/现任政府官员Former/incumbentgovernmentofficial职位Position________________________□军人Militarypersonnel职位Position________________________□非政府组织人员NGOstaff□宗教人士Religiouspersonnel□新闻从业人员Staffofmedia□其他(请说明)Other(Pleasespecify):1.16受教育程度Education□研究生Postgraduate□大学College□其他(请说明)Other(Pleasespecify):1.17工作单位/学校Employer/School名称Name联系电话Phonenumber地址Address邮政编码ZipCode第2页共4页/Page2of4二、旅行信息Part2:TravelInformation1.18家庭住址Homeaddress1.19邮政编码ZipCode1.20电话/手机Home/mobilephonenumber1.21电子邮箱E-mailaddress1.22婚姻状况Maritalstatus□已婚Married□单身Single□其他Other(Pleasespecify):1.23主要家庭成员(配偶、子女、父母等,可另纸)Majorfamilymembers（spouse,children,parents,etc.,maytypeonseparatepaper）姓名Name国籍Nationality职业Occupation关系Relationship1.24紧急联络人信息EmergencyContact姓名Name手机Mobilephonenumber与申请人的关系Relationshipwiththeapplicant1.25申请人申请签证时所在的国家或地区Countryorterritorywheretheapplicantislocatedwhenapplyingforthisvisa2.1申请入境事由Majorpurposeofyourvisit□官方访问OfficialVisit□常驻外交、领事、国际组织人员Asresidentdiplomat，consulorstaffofinternationalorganization□旅游Tourism□交流、考察、访问Non-businessvisit□永久居留Aspermanentresident□商业贸易Business&Trade□工作Work□人才引进Asintroducedtalent□寄养Aschildinfostercare□执行乘务Ascrewmember□过境Transit□短期探望中国公民或者具有中国永久居留资格的外国人Short-termvisittoChinesecitizenorforeignerwithChinesepermanentresidencestatus□与中国公民或者具有中国永久居留资格的外国人家庭团聚居留超过180日Familyreunionforover180dayswithChinesecitizenorforeignerwithChinesepermanentresidencestatus□短期探望因工作、学习等事由在中国停留居留的外国人Short-termvisittoforeignerresidinginChinaduetowork,studyorotherreasons□长期探望因工作、学习等事由在中国居留的外国人AsaccompanyingfamilymemberofforeignerresidinginChinaduetowork,studyorotherreasons□短期学习Short-termstudyforlessthan180days□长期学习Long-termstudyforover180days□短期采访报道Asjournalistfortemporarynewscoverage□外国常驻中国新闻机构记者Asresidentjournalist□其他(请说明)Other(Pleasespecify)：2.2计划入境次数Intendednumberofentries□一次(自签发之日起3个月有效)Oneentryvalidfor3monthsfromthedateofissue□二次(自签发之日起3-6个月有效)Twoentriesvalidfor3to6monthsfromthedateofissue□半年多次（自签发之日起6个月有效)Multipleentriesvalidfor6monthsfromthedateofissue□一年多次（自签发之日起1年有效)Multipleentriesvalidfor1yearfromthedateofissue□其他（请说明）Other(Pleasespecify):2.3是否申请加急服务Areyouapplyingforexpressservice?注：加急服务须经领事官员批准，将加收费用。Note:Expressserviceneedsapprovalofconsularofficials,andextrafeesmayapply.□是Yes□否No2.4本次行程预计首次抵达中国的日期ExpecteddateofyourfirstentryintoChinaonthistrip(yyyy-mm-dd)第3页共4页/Page3of4三、其他事项Part3:OtherInformation3.1是否曾在中国超过签证或居留许可允许的期限停留？HaveyoueveroverstayedyourvisaorresidencepermitinChina?□是Yes□否No3.2是否曾经被拒绝签发中国签证,或被拒绝进入中国？HaveyoueverbeenrefusedavisaforChina,orbeenrefusedentryintoChina?□是Yes□否No3.3是否在中国或其他国家有犯罪记录？DoyouhaveanycriminalrecordinChinaoranyothercountry?□是Yes□否No3.4是否具有以下任一种情形Areyouexperiencinganyofthefollowingconditions?①严重精神障碍Seriousmentaldisorder②传染性肺结核病Infectiouspulmonarytuberculosis③可能危害公共卫生的其他传染病Otherinfectiousdiseaseofpublichealthhazards□是Yes□否No3.5近30日内是否前往过流行性疾病传染的国家或地区？Didyouvisitcountriesorterritoriesaffectedbyinfectiousdiseasesinthelast30days?□是Yes□否No3.6如果对3.1到3.5的任何一个问题选择“是”，请在下面详细说明。IfyouselectYestoanyquestionsfrom3.1to3.5,pleasegivedetailsbelow.2.5预计行程中单次在华停留的最长天数LongestintendedstayinChinaamongallentriesDays2.6在中国境内行程（按时间顺序,可附另纸填写）ItineraryinChina(intimesequence，maytypeonseparatepaper)日期Date详细地址Detailedaddress2.7谁将承担在中国期间的费用？WhowillpayforyourtravelandexpensesduringyourstayinChina?2.8中国境内邀请单位或个人信息InformationofinviterinChina姓名或名称Name地址Address联系电话Phonenumber与申请人关系Relationshipwiththeapplicant2.9是否曾经获得过中国签证？如有，请说明最近一次获得中国签证的时间和地点。HaveyoueverbeengrantedaChinesevisa?Ifapplicable,pleasespecifythedateandplaceofthelasttimeyouweregrantedthevisa.2.10过去12个月中访问的其他国家或地区Othercountriesorterritoriesyouvisitedinthelast12months第4页共4页/Page4of4四、声明及签名Part4:Declaration&Signature五、他人代填申请表时填写以下内容Part5：Iftheapplicationformiscompletedbyanotherpersonontheapplicant'sbehalf,pleasefillouttheinformationoftheonewhocompletestheform3.7如果有本表未涉及而需专门陈述的其他与签证申请相关的事项，请在此或另纸说明。Ifyouhavemoreinformationaboutyourvisaapplicationotherthantheabovetodeclare,pleasegivedetailsbelowortypeonaseparatepaper.3.8如申请人护照中的偕行人与申请人一同旅行，请将偕行人照片粘贴在下面并填写偕行人信息。Ifsomeoneelsetravelsandsharesthesamepassportwiththeapplicant,pleaseaffixtheirphotosandgivetheirinformationbelow.偕行人信息Information偕行人1Person1粘贴照片于此AffixPhotohere偕行人2Person2粘贴照片于此AffixPhotohere偕行人3Person3粘贴照片于此AffixPhotohere姓名Fullname性别Sex生日DOB(yyyy-mm-dd)4.1我声明，我已阅读并理解此表所有内容要求，并愿就所填报信息和申请材料的真实性承担一切法律后果。IherebydeclarethatIhavereadandunderstoodallthequestionsinthisapplicationandshallbearallthelegalconsequencesfortheauthenticityoftheinformationandmaterialsIprovided.4.2我理解，能否获得签证、获得何种签证、入境次数以及有效期、停留期等将由领事官员决定，任何不实、误导或填写不完整均可能导致签证申请被拒绝或被拒绝进入中国。Iunderstandthatwhethertoissueavisa,typeofvisa,numberofentries,validityanddurationofeachstaywillbedeterminedbyconsularofficial,andthatanyfalse,misleadingorincompletestatementmayresultintherefusalofavisaforordenialofentryintoChina.4.3我理解，根据中国法律，申请人即使持有中国签证仍有可能被拒绝入境。Iunderstandthat,accordingtoChineselaw,applicantmayberefusedentryintoChinaevenifavisaisgranted.申请人签名日期Applicant’ssignature:Date(yyyy-mm-dd):注：未满18周岁的未成年人须由父母或监护人代签。Note:Theparentorguardianshallsignonbehalfofaminorunder18yearsofage.5.1姓名Name5.2与申请人关系Relationshipwiththeapplicant5.3地址Address5.4电话Phonenumber5.5声明Declaration我声明本人是根据申请人要求而协助填表，证明申请人理解并确认表中所填写内容准确无误。IdeclarethatIhaveassistedinthecompletionofthisformattherequestoftheapplicantandthattheapplicantunderstandsandagreesthattheinformationprovidedistrueandcorrect.代填人签名/Signature：日期/Date(yyyy-mm-dd):