visaengl-3 申根签证表格.pdf

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1、StampembassyOrconsulateApplicationforSchengenVisaPhotoThisapplicationformisfreeN°12225*011.Surname(s)familyname(s))FOREMBASSY/CONSULATEUSEONLY2.Surname(s)atbirth(earlierfamilyname(s))Dateapplication:3.Firstnames(givennames)4.Dateofbirth(year-month-day)5.ID-num

2、ber(optional)Filehandledby:6.PlaceandcountryofbirthSupportingdocuments:7.Currentnationality/ies8.Originalnationality(nationalityatbirth)ValidpassportFinancialmeans9.Sex10.Maritalstatus:InvitationMaleFemaleSingleMarriedSeparatedDivorcedWidow(er)OtherMeansoftran

3、sportHealthinsuranceOther:11.Father’sname12.Mother’sname13.Typeofpassport:NationalpassportDiplomaticpassportServicepassportTraveldocument(1951Convention)Alien’spassportSeaman’spassportOthertraveldocument(pleasespecify):…………………………………………………………………………………….…14.Numb

4、erofpassport15.Issuedby16.Dateofissue17.Validuntil18.Ifyouresideinacountryotherthanyourcountryoforigin,haveyoupermissiontoreturntothatcountry?NoYes,(numberandvalidity)……………….……………………………………………………*19.CurrentoccupationVisa:*20.Employerandemployer’saddressandtelep

5、honenumber.Forstudents,nameandaddressofschool.RefusedGrantedCharacteristicsofVisa:21.Maindestination22.TypeofVisa:23.Visa:LTVAirporttransitTransitShortstayIndividualCollectiveALongstayBCDD+C24.Numberofentriesrequested25.DurationofstayNumberofentries:Singleentr

6、yTwoentriesMultipleentriesVisaisrequestedfor:______days26.Othervisas(issuedduringthepastthreeyears)andtheirperiodofvalidity12Multiple27.Inthecaseoftransit,haveyouanentrypermitforthefinalcountryofdestination?Validfrom………………..NoYes,validuntil:Issuingauthority:To

7、…………………………*28.PreviousstaysinthisorotherSchengenstatesValidfor:…………………………….*Thequestionsmarkedwith*donothavetobeansweredbyfamilymembersofEUorEEAcitizens(spouse,childordependentascendant).FamilymembersofEUorEEAcitizenshavetopresentdocumentstoprovethisrelationsh

8、ip.29.PurposeoftravelFOREMBASSY/TourismBusinessVisittoFamilyorFriendsCultural/SportsOfficialMedicalreasonsCONSULATEUSEONLYOther(pleasespecify):….……………………………………………………..*30.Dateofarr