NON-IMMIGRANT VISA TOURIST VISA TRANSIT VISA

OTHER………….

ROYAL THAI CONSULATE– GENERAL, XI’AN

APPLICATION FOR VISA

英文填写

Name (Mr. / Mrs. /Ms.) 姓名（大写字母）_________________________________ Nationality

国籍 __________________________________________ Date of Birth

出生日期 ______________________________________ Place of Birth

出生地 ________________________________________ Profession (present)

现职业 ________________________________________ Marital Status

婚姻状况 ______________________________________ Present address

现住址 ________________________________________ _______________________________________________ Permanent address (if different from above) 永久地址（如与现住址不同，请注明）

_______________________________________________ _______________________________________________ Passport No.

护照号码 ______________________________________

Countries for which passport is valid

护照适用国 _____________________________________ Date of previous visits to Thailand

上次赴泰日期 ___________________________________ Purpose of visit

访问目的 _______________________________________ Date of arrival in Thailand

入泰时间 _______________________________________ By Flight No.

班机号 _________________________________________ Duration of proposed stay

停留时间 _______________________________________ Local guarantor and address

本国担保人姓名及地址 ___________________________ ________________________________________________ Reference person and/or address in Thailand 泰国联系人及/ 或地址

________________________________________________ ________________________________________________

Name, dates and places of birth of minor children holding the same passport and if accompanying you

Issued at 有否用本护照儿童随行，如有请填写姓名,出生地

签发地 ________________________________________ 及出生日期 _____________________________________ Date of issue ________________________________________________

Signature 签发日期 ______________________________________

Expiry date 签名 ______________________________________

Date 有效日期至 ____________________________________

日期 ______________________________________

ATTENTION FOR APPLICANT : I hereby declare that the above mentioned information is correct and that in no case shall I violate Thai laws and regulation in the country. 在此我声明所填内容属实，并保证不违反泰国的法规.

_____________________________________________________________________________________________________

FOR OFFICIAL USE （以下由使馆填写） FEE PAID

Type of visa and No. ______________________Expiry date___________________________

Date of issue ____________________________Signature ____________________________

***The visa processing fee is non-refundable. ( 已缴交之手续费在任何情况下，不获退还。

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