Form V.2013

Form V.2013 中华人民共和国签证申请表 중화인민공화국비자신청서 Visa Application Form of the People s Republic of China (For the Mainland of China only) 신청인은사실에근거하여정확하게신청서를작성하고, 모든항목은빈칸에한글또는영문대문자로기재하며, 칸에는해당사항을 로표시하시기바랍니다. 만약해당사항이없을경우 없음 이라고기재해주시기바랍니다. 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. 1. 개인정보 Part 1: Personal Information 1.1 영문이름 Full English name as in passport 1.2 한자이름 in Chinese 성 Last name Middle name 명 First name 1.4 성별 Sex 남 M 여 F 1.6 현재국적 Current nationality(ies) 1.8 출생지 ( 시 도 국 ) Place of birth(city, province/state,country) 1.9 주민등록번호 Local ID/ Citizenship number 1.3 기타이름 Other name(s) 1.5 생년월일 DOB(yyyy-mm-dd) 1.7 이전국적 Former nationality(ies) 최근촬영한정면탈모으로옅은색바탕의여권용한장을부착합니다. /Photo Affix one recent color passport photo (full face, front view, bareheaded and against a plain light colored background). 1.10 여권종류 Passport/Travel document type 외교 Diplomatic 일반 Ordinary 관용 Service or Official 1.11 여권번호 Passport number 1.13 여권발급지 Place of issue 사업가 Businessperson 회사원 Company employee 연예인 Entertainer 1.12 여권발급일자 Date of issue(yyyy-mm-dd) 1.14 여권만료일자 Date of expiry(yyyy-mm-dd) 전 / 현직의원 Former/incumbent member of parliament 전 / 현직공무원 Former/incumbent government official 1.15 직업 ( 복수선택가능 ) Current occupation(s) 1.16 최종학력 Education 1.17 직장 / 학교 Employer/School 농 공업인 Industrial/Agricultural worker 학생 Student 승무원 Crew member 자영업 Self-employed 무직 Unemployed 퇴직 Retired 석, 박사 Postgraduate 명칭 주소 Address 현역군인 Military personnel 비정부기구직원 NGO staff 종교인 Religious personnel 언론인 Staff of media 대졸 College 전화번호 Phone number 우편번호 Zip Code 第 1 页共 4 页 / Page 1 of 4

1.18 자택주소 Home address 1.20 자택전화 / 휴대전화 Home/mobile phone number 1.19 우편번호 Zip Code 1.21 이메일 E-mail address 1.22 혼인여부 Marital status 기혼 Married 미혼 Single 기타 Other(Please specify): 1.23 가족사항 ( 배우자 자녀 부모등, 별첨가능 ) Major family members(spouse, children,parents,et c.,may type on separate paper) 성명 국적 Nationality 직업 Occupation 관계 Relationship 1.24 비상연락처 Emergency Contact 성명 신청인과의관계 1.25 비자신청시신청인의소재국가또는지역 Country or territory w the applicant is located when applying for this visa 휴대전화 Mobile phone number 2. 여행정보 Part 2: Travel Information 2.1 방문목적 Major purpose of your visit 공무 Official Visit 관광 Tourism 교류, 견학, 방문 Non-business visit 무역 Business & Trade 인재초빙 As introduced talent 승무원 As crew member 경유 Transit 중국인혹은중국영구체류자격을소지한 외국국적자를단기방문 Short-term visit to Chinese citizen or foreigner with Chinese permanent residence status 업무, 학업등의사유로중국에체류중인외국 국적자를단기방문 Short-term visit to foreigner residing in China due to work, study or other reasons 단기유학 (180 일이하 ) Short-term study for less than 180 days 단기취재 As journalist for temporary news coverage 기타 ( 설명필요 )Other (Please specify): 상주외교 영사 국제기구직원 As resident diplomat,consul organization 영구체류 As permanent resident 취업 Work 위탁양육 As child in foster care or staff of international 중국인혹은중국영구체류자격을소지한 외국국적자의가족으로, 180 일이상체류 Family reunion for over 180 days with Chinese citizen or foreigner with Chinese permanent residence status 업무, 학업등의사유로중국에체류중인외국 국적자가족동반 As accompanying family member of foreigner residing in China due to work, study or other reasons 장기유학 (180 일이상 ) Long-term study for over 180 days 기자상주 ( 특파원 ) As resident journalist 1 차입국 ( 발급일로부터 3 개월이내유효 ) One entry valid for 3 months from the date of issue 2.2 희망입국차수 Intended number of entries 2 차입국 ( 발급일로부터 3-6 개월이내유효 ) Two entries valid for 3 to 6 months from the date of issue 6 개월복수입국 ( 발급일로부터 6 개월이내유효 ) Multiple entries valid for 6 months from the date of issue 1 년복수입국 ( 발급일로부터 1 년이내유효 ) Multiple entries valid for 1 year from the date of issue 기타 ( 설명필요 )Other (Please specify): 2.3 급행서비스를원하십니까? Are you applying for express service? 주의 : 담당영사의승인이반드시필요하며별도의비용이부과됩니다. Note: Express service needs approval of consular officials, and extra fees may apply. 2.4 중국입국예정일 Expected date of your first entry into China on this trip (yyyy-mm-dd) 예 Yes 아니오 No 第 2 页共 4 页 / Page 2 of 4

2.5 중국방문최장체류기간 Longest intended stay in China among all entries Days 날짜 Date 상세주소 Detailed address 2.6 중국방문일정 ( 시간순으로작성, 일정표별첨가능 ) Itinerary in China (in time sequence,may type on separate paper) 2.7 중국방문시누가경비를부담합니까? Who will pay for your travel and expenses during your stay in China? 이름또는기관명칭 2.8 중국내초청기관, 또는개인인적사항 Information of inviter in China 주소 Address 전화번호 Phone number 신청인과의관계 2. 9 이전에중국비자를받은적이있습니까? 있다면, 가장최근의비자발급일자와발급지를기재해주십시오. 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. 2.10 지난 1 년간방문한기타국가혹은지역 Other countries or territories you visited in the last 12 months 3. 기타사항 Part 3: Other Information 3.1 이전에중국비자혹은거류허가기간을초과한적이있습니까? Have you ever overstayed your visa or residence permit in China? 3.2 이전에중국비자또는중국입국이거부된적이있습니까? Have you ever been refused a visa for China, or been refused entry into China? 3.3 이전에중국또는기타국가에서범죄기록이있습니까? Do you have any criminal record in China or any other country? 3.4 다음과같은질병이있습니까? Are you experiencing any of the following conditions? 1심각한정신질환 Serious mental disorder 2전염성폐결핵 Infectious pulmonary tuberculosis 3공공위생및질서에위해가능성이있는기타전염성질환 Other infectious disease of public health hazards 3.5 최근 30 일이내에유행성전염병이발생한국가또는지역을방문한적이있습니까? Did you visit countries or territories affected by infectious diseases in the last 30 days? 3.6 만약 3.1 ~ 3.5 항목중 예 에해당할경우, 그사유를상세히작성해주시기바랍니다. If you select Yes to any questions from 3.1 to 3.5, please give details below. 第 3 页共 4 页 / Page 3 of 4

3.7 만약비자신청과관련하여신청서에포함되지는않았으나추가로기재가필요한사항이있다면상세히작성해주시기바라며, 별첨가능합니다. 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. 3.8 동반여권으로동반자와함께비자를신청할경우동반자의을부착하고동반자의인적사항을작성해주시기바랍니다. If someone else travels and shares the same passport with the applicant, please affix their photos and give their information below. 동반자인적사항 Information 동반자 1 Person 1 동반자 2 Person 2 동반자 3 Person 3 성명 Full name 성별 Sex 생년월일 DOB(yyyy-mm-dd) 4. 성명및서명 Part 4: Declaration & Signature 4.1 본인은신청서의모든항목을숙지하였고, 작성한내용과제출서류에대한모든법적인책임을지겠습니다. I by 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. 4.2 본인은비자의발급가능여부, 종류, 입국차수, 유효기간, 체류기간등은모두영사가결정하며, 허위사실기재나신청서부실기재등으로인해비자발급또는중국입국이거부될수있음을숙지하는바입니다. 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. 4.3 본인은중국법률에의거, 중국비자를소지하고있더라도입국이거부될수있음을숙지하는바입니다. I understand that, according to Chinese law, applicant may be refused entry into China even if a visa is granted. 신청인서명 Applicant s signature: 날짜 Date (yyyy-mm-dd): 주의 : 만 18 세미만의미성년자는부모또는후견인이대필할수있습니다. Note: The parent or guardian shall sign on behalf of a minor under 18 years of age. 5. 타인이신청서를대필하였을경우아래내용을작성하여주시기바랍니다. 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 5.1 성명 5.2 신청인과의관계 5.3 주소 Address 5.4 전화번호 Phone number 5.5 성명 Declaration 다음과같이성명합니다. 본인은신청인의요구에따라신청서를작성하였으며, 신청인은신청서의내용을정확히이해하고확인하였음을증명합니다. 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. 대필자서명 /Signature: 날짜 /Date (yyyy-mm-dd): 第 4 页共 4 页 / Page 4 of 4

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