Visa Application - Consulate General Of Viet Nam Perth - Australia

CONSULATE GENERAL OF VIET NAM

VISA APPLICATION

(

*

)

PERTH – AUSTRALIA

Photograph

Level 8, 16 St Georges Terrace WA 6000

 PO Box 3122, East Perth, WA 6892

 (08) 9325 3642 - 9221 1158

 vnvisawa@iinet.net.au



1. Full name (in CAPITALS): .........................................................................................................................................................................

Family name

Middle name

First name

2. Date of birth

……../……../……………

8. Purpose to visit Viet Nam







DD

MM

YYYY

Tourism

Business

Other

 Male

 Female

3. Sex

9. Proposed date of entry

……../……../……………

4. Nationality: ........................................................................

DD

MM

YYYY

Proposed date of exit

……../……../……………

5. Passport number:

........................................................

DD

MM

YYYY

Date of expiry:

……../……../……………

10. Type of visa requested:

6. Occupation:

........................................................

 Single entry

 Multiple entries

7. Current contact (required):

Length of stay

Address (NOT PO Box, please): ...................................

 1 (one) month

...............................................................................................

 3 (three) months

 Less than 6 (six) months (with approval only)

...............................................................................................

 Up to 1 (one) year (with approval only)

...............................................................................................

Email: ..................................................................................

Mobile phone: .................................................................

I hereby declare that the statements in this application form are true and correct.

Signature: ………………………………………………………………….

Date:

……../……../……………

(DD / MM / YYYY)

( Copy of passport is also acceptable

)

*

Check list:

 Original passport (with at least 6 months validity from the date of exit)

 This application form

 Visa fee (cash or bank cheque only)

 (Optional) Prepaid envelop of Registered/Express Post with SOD to return passport via post

Disclaimer:

- Applicants are fully responsible for checking information on the visa. If any error found, please report immediately to

the Consulate General for correction. The Consulate General holds no responsibility for unreported mistakes/error.

- In case of emergency, please call (+61) 478719141 or (+61) 434520536