Form V.2011a - Visa Application Form Of The People'S Republic Of China Page 5
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11Fill in all fields on this PDF form. Answer "N/A" or "None" if needed; do not leave any fields blank.
Form V.2011A
Visa Application Form of the People’s Republic of China
Applicant should fill out this form truthfully and completely
on a computer and print out. Please type your answer in capital English letters in the space provided or cross the appropriate box to
select. Please state “N/A” or “None” if a section does not apply to you. If there is additional information to declare, please type on a
separate sheet.
(Form V.2011B)
Please also complete the Supplementary Visa Application Form (Form V.2011B) if you are not a U.S. citizen, or if you are applying
for work visa or student visa, or if you will be accompanied by anyone who shares the same passport with you.
Section 1 Personal information
1.2
Surname
M
Sex
1.1
F
Full name as shown
Photo requirements
Given name
on your passport
(First & Middle)
1.3
N/A
1
One colored photo
(or "N/A")
Name in Chinese character ( if applicable)
6
Within 6 months
Passport photo
1.4
Front-facing
Other name or previous name
Hatless
(or "N/A")
if applicable
Light-colored
background
Full Name in English or
1.5
Name in native language
1.6
1.7
(or "N/A")
Current nationality
Former nationality
1.8
1.9
Concurrent nationality
Date of birth (yyyy-mm-dd)
(or "N/A")
1.10
1.11
Place of birth (city,
U.S. ID card number
province/state, country)
(Driver's License)
Married
Never Married
Divorced
1.12
Marital status
Widowed
Other Please specify :
.
Businessman
Government official
Company employee
Staff of media
Teacher
Religious worker
1.13
Student
Active duty military personnel
Housewife
Member of national parliament
Current
occupation(s)
Unemployed
Crew member
Retired
Other (Please specify):
.
Diplomatic passport
/
Service/Official passport
1.14
Passport type
Ordinary passport
Other (Please specify):
.
1.15
1.16
Passport number
Date of issue (yyyy-mm-dd)
1.17
1.18
Place of issue (city, province/state,
Expiry date (yyyy-mm-dd)
country)
th
th
Normal (the 4
or 5
working day)
1.19
Please select pick-up day (Extra fee is charged for express pick-up)
nd
rd
Express (the 2
or 3
working day)
CNNYCONSULATE JUNE 2011 EDITION
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