Section 3: Information about your family, work or study
Current home address
Home phone number
Name, phone number and
address of your current
employer or school
(List company name and
brief description of the
industry, such as "Smith and
Smith LLC- attorneys" or
"Self-Employed - architect.")
Major family members
(Fill in details for spouse and
all family members who live
with you. If you live alone, list
at least one close relative.)
Contact person in case of
Section 4: Other information
Have you ever visited China
before? If “Yes”, please specify date, places and purpose of the
Have you ever visited other
countries or territories in the past 12 months? If “yes”, please
specify date, name of countries or territories and purpose of the
Have you ever overstayed your visa or residence permit in China?
Have you ever been refused a visa for China, or been refused entry into China?
Do you have any criminal record in China or any other country?
? Are you suffering from any of the following diseases?
Serious mental disorder
Infectious pulmonary tuberculosis
Other infectious disease of public health hazards
Did you visit countries or territories infected by infectious diseases in the past 30 days?
CNNYCONSULATE JUNE 2011 EDITION
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