常用国家签证办理指南因私护照签证申请表及签证材料埃塞俄比亚签证申请表

Embassy of the Federal Democratic Republic of Ethiopia Beijing Visa Application Form 埃塞俄比亚联邦民主共和国驻华使馆 签证申请表 （请用英文填写） Request No. _________________ Given Name/名 _______________________ Middle Name _______________________ Surname/姓 _______________________ Sex/性别: ( Male (男) ( Female (女) Nationality/国籍 _______________________ Date of Birth/出生日期 ________________ Place of Birth/出生地 ________________ Profession/现职业 _________________ Home address/家庭住址 _______________________________________________________________________________________ Permanent address (if different from above)/永久地址（如与家庭住址不同，请注明） __________________________________________________________________________________________________________ Passport type/护照种类: ( Ordinary (普通) ( Diplomatic (外交) ( Service (公务) ( Others (其他) ____________________ Passport No./护照号码 ___________________________ Issued at/签发地 ________________ Date of issue/签发日期 _______________ Expiry date/有效期至 _____________________ Name, dates and places of birth of children dependents holding the same passport and if accompanying you/有否用同本护照的 儿童随行，如有请填写姓名，出生地及出生日期 ____________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ Purpose of visit/访问目的: ( Business (商务) ( Tourism (旅游) ( Transit (过境) ( Other (其他) __________________ Entries/入境次数: ( Single (单次) ( Double (两次) ( Multiple (多次) Date of arrival in Ethiopia/入埃时间 ___________________________ by (Flight No.)/所乘航班号 _______________________ Duration of proposed stay/停留时间 ___________________________ Name and address of present employer /现所在单位名称及地址 ______________________________________________________ Reference person and/or address in Ethiopia/埃国联系人及/或地址 ____________________________________________________ ATTENTION FOR APPLICANT I, the under signed, hereby declare that the above mentioned information is correct and that no case shall I violate Ethiopian laws and regulations while in the country. 在此我声明所填内容属实，并保证不违反埃塞俄比亚的法规 Signature/签名 __________________________ Date/日期 _______________________________ TO BE FILLED AT HEAD OFFICE （以下部分由使馆填写） Date of Entry _______________ Port of Entry _______________ Visa No. _______________ Visa Type _______________ Place of Issue ____________________ Date of Issue ____________________ Date of Expiry ____________________ Address in Ethiopia: Hotel _______________ Tel _______________ Contact Person _______________ Phone _______________ Photo 照片