1 Form Reset Form . visa Application Form of the People's Republic of China (For the Mainland of China only).. The applicant should fill in this form truthfully completely and clearly. Please type the answer in capital English letters in the space provided or tick ( ) the relevant box to select. If some of the items do not apply , please type N/A or None. Part 1: Personal Information Last name .. Full English . Middle name name as in passport /Photo First name Affix one recent color passport photo (full face , Name in Chinese Other name(s) front view ,bareheaded and against a plain light colored background). Sex M F. DOB (yyyy-mm-dd).. Former Current nationality(ies). nationality(ies). ( / ) Place of birth(city,province/state , country). / . Driver license /Citizenship number / Diplomatic Service or Official Passport/Travel Ordinary ( ) Other (Please specify) : document type Date of Passport number issue(yyyy-mm-dd).
2 Date of Place of issue expiry(yyyy-mm-dd). Business person / Former/incumbent member of parliament Company employee Position Entertainer / Former/incumbent government official / Industrial/Agricultural worker Position / Teacher/Student Military personnel Crew member Position Current Occupation Self-employed NGO staff (s) Unemployed Religious personnel Retired Staff of media ( ) Other (Please specify) : Postgraduate College Education ( ) Other (Please specify) : .. Phone / Name number Employer /.. School Address Zip Code 1 4 / Page 1 of 4.. Home address Zip Code / .. Home/mobile phone E-mail number . Married Single Other (Please specify): Marital status Name Nationality Occupation Relationship ( . , ) Major family members spouse ,children , parents etc. , may type on separate paper . Mobile Name phone number Emergency Relationship Contact with the applicant Country or territory where the applicant is located when applying for this visa Part 2: Travel Information Official Visit As resident Tourism diplomat consul or staff of international Non-business visit organization Business & Trade As permanent resident As introduced talent Work As crew member As child in foster care Transit.
3 180 Family reunion for over 180. Short-term visit to Chinese citizen or Major days with Chinese citizen or foreigner with Chinese foreigner with Chinese permanent residence status purpose permanent residence status of your . visit Short-term visit to foreigner residing in As accompanying family member of foreigner residing China due to work ,study or other reasons in China due to work ,study or other reasons Short-term study for less than 180 days Long-term study for over 180 days As journalist for temporary news As resident journalist coverage ( ) Other (Please specify) . ( 3 ) One entry valid for 3 months from the date of issue . ( 3-6 ) Two entries valid for 3 to 6 months from the date of issue . Intended 6 ) Multiple entries valid for 6 months from the date of issue number 1 ) Multiple entries valid for 1 year from the date of issue of entries Other (Please specify) : Are you applying for 2 Rush-Next working day pickup expedited service?
4 Note: Approval of 3 Express-3rd working day pickup consular officials is required for expedited 4 Regular-4th working day pickup service , and extra fees may apply.. Expected date of your first entry Longest intended Days into China on this trip (yyyy-mm-dd) stay in China among all entries 2 4 / Page 2 of 4. Date Detailed address .. , .. Itinerary in China (in time sequence may type on separate paper). Who will pay for your travel and expenses during your stay in China? . Name . Address Information of . inviter in China . Relationship with Phone number the applicant . Have you ever been granted a Chinese visa ? If applicable ,please specify the date and place of the last time you were granted the visa . 12 Other countries or territories you visited in the last 12 months Part 3: Other Information Have you Yes No ever overstayed your visa or residence permit in China?
5 , Have you ever Yes No been refused a visa for China ,or been refused entry into China? Do you have any criminal Yes No record in China or any other country? Are you experiencing any of the following conditions? Serious mental disorder Yes No Infectious pulmonary tuberculosis Other infectious disease of public health hazards 30 Did you visit Yes No countries or territories affected by infectious diseases in the last 30 days? . If you select Yes to any questions from to ,please give details below. 3 4 / Page 3 of 4. If you have more information about your visa application other than the above to declare , please give details below or type on a separate paper. If someone else travels and shares the same passport with the applicant ,please affix their photos and give their information below. 1 Person 1 2 Person 2 3 Person 3.
6 Information Affix Photo Affix Photo Affix Photo here here here Full name Sex DOB. (yyyy-mm-dd). Part 4: Declaration & Signature . I hereby declare that I have read and understood all the questions in this application and shall bear all the legal consequences for the authenticity of the information and materials I provided.. I understand that whether to issue a visa , type of visa , number of entries , validity and duration of each stay will be determined by consular official , and that any false , misleading or incomplete statement may result in the refusal of a visa for or denial of entry into China.. I understand that ,according to Chinese laws ,applicant may be refused entry into China even if a visa is granted. Applicant's signature : Date (yyyy-mm-dd) : 18 Note: The parent or guardian shall sign on behalf of a minor under 18.
7 Years of age. Part 5 If the application form is completed by another person on the applicant's behalf, please fill out the information of the one who completes the form .. Relationship with the Name applicant . Phone number Address Declaration . I declare that I have assisted in the completion of this form at the request of the applicant and that the applicant understands and agrees that the information provided is true and correct. /Signature /Date (yyyy-mm-dd) : 4 4 / Page 4 of 4.