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1、 VISA APPLICATION FORM 签证申请表 Application form should be filled in fully and accurately in capital letters,submitted with passport,which is valid.Please,ensure that the photograph is attached.请准确、完整地填写申请表并提交护照及其复印件和照片.1.Full Name 姓名 (as in passport)(pinyin)2.Nationality 国籍：3.Sex 性别：4.Marital Status 婚
2、姻状况：5.Date of Birth 出生日期：6.Place of Birth 出生地点：7.Passport Number：护照号码：8.Issued by 签发单位：9.Expiration Date:有效期至：10.Permanent Home Address:家庭地址:_ Country:City/Province:Apartment No.国家:_ 省/市_ 楼,房号:_ Street/Village:Phone:Mobile:街道/乡村_ 电话_ 手机_ 11.ID card Place of issue:身份证编号:签发单位：12.If any children accomp
3、anying applicant are included in his/her passport,give the details 如有孩子同行,请写明:Name 姓名,Place and date of birth 出生日期,地点 Sex 性别 _ 13.Occupation,office address,tel:申请者工作单位地址,电话和职务:CONSUL DIVISION OF THE EMBASSY OF THE KYRGYZ REPUBLIC TO THE PEOPLES REPUBLIC OF CHINA 吉尔吉斯共和国驻华大使馆领事处 Affix the photo here
4、近三个月免冠 照片 14.Purpose of trip：去吉尔吉斯共和国的目的：15.Type of Visa Requested:签证类型：:16.Date of Entry:进入吉尔吉斯共和国日期：17.Date of Exit：离开吉尔吉斯共和国日期：18.Places to be visited：去的地点：19.Do you intend to work in Kyrgyzstan:是否打算在吉尔吉斯共和国工作 20.Names,Address and Phone No.of the Inviting Party in Kyrgyzstan:邀请方名称、地址和电话:21.Number
5、 of previous trips to Kyrgyzstan 去过吉尔吉斯共和国次数 22.Date of the latest trip 最后一次去吉尔吉斯共和国日期 23.If permission to visit to Kyrgyzstan or extend stay in Kyrgyzstan has been refused previously,if so,when&by whom 在办理签证或者签证延期时，是否有过被拒绝，如果有，什麽时间被什麽机构在什麽地方 _ 24.Was this Application prepared by another person on y
6、our behalf,if so,His/Her name:Relationship to Applicant:Occupation:Address:Phone:His/Her Signature:如果该申请表由他人代为填写，请注明填写人姓名、与签证申请人的关系、联系地址、电话、职业。_ 25.I hereby declare that the information given above is true,correct and complete.I understand that any false or misleading statement may result in the permanent refusal of a visa or denial of entry into the Kyrgyz Republic.我确认，以上填写内容真实、完整。我明白，任何虚假内容或者误导都可导致永久拒签。Date 填表日期:_ Applicants Signature 签名:_ FOR OFFICIAL USE ONLY/公务记号 :.:200_.:200_.:200_.:
吉尔吉斯签证申请表1210
