출입국관리법시행규칙 [ 별지제 17 호서식 ] ( 제 1 쪽 / Page1) APPLICATION FOR VISA < 신청서작성방법 > 신청인은사실에근거하여빠짐없이정확하게신청서를작성하여야합니다. 신청서상의모든질문에대한답변은한글또는영문으로기재하여야합니다. 선택사항은해당칸 [ ] 안에 표시를하시기바랍니다. 기타 를선택한경우, 상세내용을기재하시기바랍니다. <How to fill out this form> You must fill out this form completely and correctly. You must write in block letters either in English or Korean. For multiple-choice questions, you must check [ ] all that apply. If you select Other, please provide us with more information in the given space. 1. 인적사항 / PERSONAL DETAILS PHOTO 여권용사진 (35 mm 45 mm ) - 흰색바탕에모자를쓰지않은정면사진으로촬영일부터 6 개월이경과하지않아야함 A color photo taken within la st 6 months(full face without hat, front view against whit e or off-white background) 1.1 여권에기재된영문성명 /Full name in English (as shown in your passport) 성 Family Name 명 Given Names 1.2 한자성명漢字姓名 1.3 성별 Sex 남성 /Male[ ] 여성 /Female[ ] 1.4 생년월일 Date of Birth (yyyy/mm/dd) 1.5 국적 Nationality 1.6 출생국가 Country of Birth 1.7 국가신분증번호 National Identity No. NZ contact phone no: Home: 1.8 이전에한국에출입국하였을때다른성명을사용했는지여부 Have you ever used any other names to enter or depart Korea? Mobile: 아니오 No [ ] 예 Yes [ ] 예 선택시상세내용기재 If Yes please provide details ( 성 Family Name, 명 Given Name ) 1.9 복수국적여부 Are you a citizen of more than one country? 아니오 No [ ] 예 Yes [ ] 예 선택시상세내용기재 If Yes please write the countries ( ) 공용란 FOR OFFICIAL USE ONLY 기본사항체류자격체류기간사증종류단수 / 더블 / 복수 접수사항접수일자접수번호처리과 허가사항허가일자인정번호고지사항 PR/Work/Student 담당자 가 [ ] 부 [ ] < 심사의견 > < 수입인지부착란 >
( 제 2 쪽 / Page2) 2. 사증발급인정서발급내용 / DETAILS OF VISA ISSUANCE CONFIRMATION 대한민국출입국관리사무소 출장소에서사증발급인정서를발급받은사람만기재 (Section 2 is only for those who possess confirmation of visa issuance issued by the Immigration Office of the Republic of Korea) 2.1 사증발급인정번호허가번호표시발급일표시 2.2 발급일 Issue Date Confirmation No. 2.3 여권번호 Passport No. 2.4 여권만료일 Passport Expiry Date 사증발급인정서를발급받은사람은 12번 ( 서약 ) 으로이동하여작성한후신청서제출 (3 ~ 11번은기재생략 ) Those who have confirmation of visa issuance must move to section 12 (Declaration) to complete this form (Those with visa issuance confirmation must not fill out section 3~11). 3. 여권정보 / PASSPORT INFORMATION 3.1 여권종류 Passport Type 외교관 Diplomatic [ ] 관용 Official [ ] 일반 Regular[ ] 기타 Other [ ] 기타 상세내용 If Other please provide details ( ) 3.2 여권번호 Passport No. 3.3 발급국가 Country of Passport 3.4 발급지 Place of Issue 3.5 발급일자 Date of Issue 3.6 기간만료일 Date Of Expiry 3.7 다른여권소지여부 Do you have any other valid passport? 아니오 No [ ] 예 Yes [ ] 예 선택시상세내용기재 If Yes please provide details a) 여권종류 Passport Type 외교관 Diplomatic [ ] 관용 Official [ ] 일반 Regular[ ] 기타 Other [ ] b) 여권번호 Passport No. c) 발급국가 Country of Passport d) 기간만료일 Date Of Expiry 4. 연락처 / CONTACT INFORMATION 4.1 본국주소 Address in Your Home Country 4.1 현거주지 Current Residential Address * 현거주지가본국주소와다를경우기재 / Write if it is different form the above address 4.3 휴대전화 Cell Phone No. 4.4 일반전화 Telephone No. 4.5 이메일 E-mail 4.6 비상시연락처 Emergency Contact Information a) 성명 Full Name in English b) 거주국가 Country of residence c) 전화번호 Telephone No. d) 관계 Relationship to you 5. 혼인사항 / MARITAL STATUS DETAILS 5.1 현재혼인사항 Current Marital Status 기혼 Married [ ] 이혼 Divorced [ ] 미혼 Never married [ ] 5.2 배우자인적사항 * 기혼으로표기한경우에만기재 If Married please provide details of your spouse a) 성 Family Name (in English) b) 명 Given Names (in English)
c) 생년월일 Date of Birth (yyyy/mm/dd) d) 국적 Nationality e) 거주지 Residential Address f) 연락처 Contact No. ( 제 3 쪽 / Page3) 6. 학력 / EDUCATION 6.1 최종학력 What is the highest degree or level of education you have completed? 석사 / 박사 Master s/doctoral Degree [ ] 대졸 Bachelor s Degree [ ] 고졸 High School Diploma [ ] 기타 Other [ ] 기타 선택시상세내용기재 If Other please provide details ( ) 6.2 학교명 Name of School 6.3 학교소재지 Location of School(city/province/country) 7. 직업 / EMPLOYMENT 7.1 직업 What are your current personal circumstances? 사업가 Entrepreneur [ ] 자영업자 Self-Employed [ ] 직장인 Employed [ ] 공무원 Civil Servant [ ] 학생 Student [ ] 퇴직자 Retired [ ] 무직 Unemployed [ ] 기타 Other [ ] 기타 선택시상세내용기재 If Other please provide details ( ) 7.2. 직업상세정보 Employment Details a) 회사 / 기관 / 학교명 Name of Company/Institute/School b) 직위 / 과정 Your Position/Course c) 회사 / 기관 / 학교주소 Address of Company/Institute/School d) 전화번호 Telephone No. 8. 초청인정보 / DETAILS OF SPONSOR 8.1 초청인 / 초청회사 Do you have anyone sponsoring you for the visa? 아니오 No [ ] 예 Yes [ ] 예 선택시상세내용기재 If Yes please provide details a) 초청인 / 초청회사명 Name of your visa sponsor (Korean, foreign resident in Korea, company, or institute) b) 생년월일 / 사업자등록번호 Date of Birth/Business Registration No. c) 관계 Relationship to you d) 주소 Address e) 전화번호 Phone No. 9. 방문정보 / DETAILS OF VISIT 9.1 입국목적 Purpose of Visit to Korea 관광 / 통과 Tourism/Transit [ ] 행사참석 /Meeting, Conference [ ] 의료관광 Medical Tourism [ ] 단기상용 Business Trip [ ] 유학 / 연수 Study/Training [ ] 취업활동 Work [ ] 무역 / 투자 / 주재 Trade/Investment/Intra- Corporate Transferee [ ] 가족또는친지방문 Visiting Family/ Relatives/Friends [ ] 결혼이민 Marriage Migrant [ ] 외교 / 공무 Diplomatic/Official [ ] 기타 Other [ ]
기타 선택시상세내용 If Other please provide details ( ) 9.2 체류예정기간 Intended Period of Stay 9.3 입국예정일 Intended Date of Entry ( 제 4 쪽 / Page4) 9.4 체류예정지 ( 호텔포함 ) Address in Korea(including hotels) 9.5 한국내연락처 Contact No. in Korea 9.6 과거 5 년간한국을방문한경력 Have you travelled to Korea in the last 5 years? 아니오 No [ ] 예 Yes [ ] 예 선택시상세내용기재 If Yes please provide details of any trips to Korea ( ) 회 times, 최근방문목적 Purpose of Recent Visit ( ) 9.7 한국이외에과거 5 년간여행한국가 Have you travelled outside your country of residence, excluding to Korea, in the last 5 years? 아니오 No [ ] 예 Yes [ ] 예 선택시상세내용기재 If Yes please provide details of these trips 국가명 Name of Country (in English) 방문목적 Purpose of Visit 방문기간 Period of Stay (yyyy/mm/dd)~ (yyyy/mm/dd) 9.8. 동반입국가족유무기재 Are you travelling to Korea with any family member? 아니오 No [ ] 예 Yes [ ] 예 선택시상세내용 If Yes please provide details of the family members you are travelling with 성명 Full name in English 생년월일 Date of Birth (yyyy/mm/dd) 국적 Nationality 관계 Relationship to you * 참고 : 가족의범위 배우자, 자녀, 부모, 형제 Note: Definition of a Family Member - your spouse, father, mother, children, brothers and sisters 10. 방문경비 / FUNDING DETAILS 10.1 방문경비 ( 미국달러기준 ) Estimated travel costs(in NZ dollars) 10.2 경비지불자 Who will pay for your travel-related expenses? (any person including yourself and/or institute) a) 성명 / 회사 ( 단체 ) 명 Name of Person/Company(Institute) b) 관계 Relationship to you c) 지원내용 Type of Support d) 연락처 Contact No. 11. 서류작성시도움여부 / ASSISTANCE WITH THIS FORM
11.1 이신청서를작성하는데다른사람의도움을받았습니까? Did you receive assistance in completing this form? 아니오 No [ ] 예 Yes [ ] 예 선택시상세내용 If Yes please provide details of the person who assisted you 성명 Full Name 생년월일 Date of Birth (yyyy/mm/dd) 연락처 Telephone No. 관계 Relationship to you ( 제 5 쪽 / Page5) 12. 서약 / DECLARATION * 사증발급인정서소지자도작성 Those who possess confirmation of visa issuance must only complete section 1,2, and 12 of this form 본인은이신청서에기재된내용이거짓없이정확하게작성되었음을확인합니다. 또한본인은대한민국의출입국관리법규정을준수할것을서약합니다. I declare that the statements made in this application are true and correct to the best of my knowledge and belief, and that I will comply with the Immigration Act of the Republic of Korea. 신청일자 ( 년. 월. 일 ) DATE OF APPLICATION (yyyy/mm/dd) / / / 신청인서명 SIGNATURE OF APPLICANT 17 세미만자의경우부모또는법정후견인의서명 Signature of Parent or Legal Guardian s for a person under 17 years of age 첨부서류 ATTACHMENT 1. 출입국관리법시행규칙 제 76 조제 1 항관련 [ 별표 5] 사증발급신청등첨부서류 유의사항 Notice 1. 위기재사항과관련하여자세한내용은별지로작성하거나관련서류를추가로제출할수있습니다. If extra space is needed to complete any item, record on a separate sheet of paper or submit relevant documents which could support your application. 2. 대한민국사증을승인받은후분실또는훼손등의사유로여권을새로발급받은경우에는, 정확한개인정보를반영할수있도록변경된여권정보를사증에통보하여야합니다. If you received Korean visa approval, and have new passport issued thereafter in lieu of lost/damaged passport, you must notify the concerned visa office of changes in your passport information. 3. 사증을발급받았더라도대한민국입국시입국거부사유가발견될경우에는대한민국으로의입국이허가되지않을수있습니다. Possession of a visa does not entitle the bearer to enter the Republic of Korea upon arrival at the port of entry if he/she is found inadmissible. 4. 출입국관리법시행규칙 제9조제1항에따라 C 계열사증소지자는입국후에체류자격을변경할수없습니다. Please note that category C visa holders are not able to change their status of stay after their entry into the Republic of Korea in accordance with Article 9(1) of the Enforcement Regulations of the Immigration Act. 처리절차 신청서작성 Application 접수 Reception 심사 Review Approval 사증발급 Issuance 신청인 Applicant ( 재외공관 )