申根签证申请表[定稿]

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1、schengenVonf0rmPHOTOForofficialuseonly1・Surname(Familyname)(x)Zhang2・Sumameatbirth(Formerfamilyname(s))(x)Dateofapplication:Visaapplicationnumber:3.Firstname(s)(Givenname(s))(x)San4.Dateofbirth(day-month-year)01JAN20005.PlaceofbirthBEIJING6・CountryofbirthCHINA7.Cu

2、rrentnationalityCHINAApplicationlodgedat□Embassy/consulate□CAC□Serviceprovider□Commercialintermediary□BorderNationalityatbirth,ifName:different:8・Sex■Male□Female9.Maritalstatus■Single□Married□Separated□Divorced□Widow(er)□Other(pleasespecify)□OtherFilehandiedby:Sup

3、port!ngdocuments:10.Inthecaseofminors:Surname,firstname,address(ifdifferentfromapplicant's)and□Traveldocumentnationalityofparentalauthority/legalguardian□Meansofsubsistenee□Invitation□Meansoftransport□TMI□Other:11.Nationalidentitynumber,whereapplicable110108200001

4、012222Visadecision:12・Typeoftraveldocument■Ordinarypassport□Diplomaticpassport□Servicepassport□Officialpassport□Specialpassport□Othertraveldocument(pleasespecify)14.Dateofissue15.Validuntil16.Issuedby01JAN201231DEC2021Exit&EntryAdministrationMinistryofPublicSecuri

5、ty13・NumberoftraveldocumentG12345678□Refused□Issued:□A□C□LTV□Valid:FromUntil17.Applicant'shomeaddressande-mailaddressRoomXXX,No.XXX,XXXRoadHaidianDistrict,Beijing,Chinaxxx@xxx.comTelephonenumber(s)13800138000Numberofentries:□1□2□MultipleNumberofdays:18.Resideneei

6、nacountryotherthanthecountryofcurrentnationality■No□Yes・ResideneepermitorequivalentNoValiduntil*19.CurrentoccupationFarmer*20.Employerandemployer'saddressandtelephonenumber・Forstudents,nameandaddressofeducationalestablishment・BeijingXXXXCo.,Ltd.RoomXXX,No.XXX,XXXR

7、oad,HaidianDistrict,Beijing,China010-8888888821.Mainpurpose(s)ofthejourney:■Tourism□Business□Visitingfamilyorfriends□Cultural□Sports□Officialvisit□Medicalreasons□Study□Transit□Airporttransit□Other(pleasespecify)22.MemberState(s)ofdestinationBelgium,Franee23.Member

8、StateoffirstentryBelgium24.Numberofentriesrequested■Singleentry□Twoentries□Multipleentries25.DurationoftheintendedstayortransitIndicatenumberofdays15Day