Application For Schengen Visa - Consolato Generale D'Italia, Ho Chi Minh City, Vietnam Page 3
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2
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422. Member State(s) of destination
23. Member State(s) of first entry
24. Number of entries requested
25. Duration of the intended stay or transit
indicate number of days
Single entry
Two entries
Multiple entries
The fields marked with * shall not be filled in by family members of EU, EEA or CH citizens (spouse, child or dependent ascendant)
while exercising their right to free movement. Family members of EU, EEA or CH citizens shall present documents to prove this
relationship and fill in the fields No. 34 and 35.
(x) Fields 1-3 shall be filled in the accordance with the data in the travel document.
26. Schengen visas issued during the past three years
No
Yes. Date(s) of validity from ………………………….. to ………………………………….
27. Fingerprints collected previously for the purpose of applying for Schengen visa
No
Yes
…………………………………………………….………………. ……………… Date, if known
28. Entry permit for the final country of destination, where applicable
29. Intended date of arrival in Schengen area
30. Intended date of departure from the Schengen
area
* 31. Surname and first name of the inviting person(s) in the Member State(s). If not applicable, name
of hotel(s) or temporary accommodation(s) in the Member State(s)
Address and e-mail address of inviting person(s)/ hotel(s)/
Telephone and telefax
temporary accommodation(s)
* 32. Name and address of inviting company/organization
Telephone and telefax of company/
organization
Surname , first name, address, telephone, telefax, and e-mail address of contract person in country/
organization
* 33. Cost of travelling and living during the applicant's stay covered
by the applicant himself/herself
by a sponsor (host, company, organization),
please specify
Mean of support
…………………….
referred to in field 31 or 32
Cash
…………………………..
other (please specify)
Traveler's cheques
Mean of support
Credit card
Cash
Prepaid accommodation
Accommodation provided
Other (please specify)
All expenses covered during the stay
Prepaid transport
Other (please specify)
34. Personal data of the family member who is an EU, EEA, or CH citizen
Surname
First name(s)
Date of birth
Nationality
Number of travel document or ID card
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