Form V.2011a - Visa Application Form Of The People'S Republic Of China Page 3
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4Section 3: Information about your family
work or study
,
3.1
Detailed home
mailing address
3.2
3.3
Home phone number
Mobile phone number
3.4
Email address
3.5
Name
Current
Mailing address
employer
or school
Phone number
Name
Nationality
Occupation
Relationship
3.6
Major
family
members
3.7
3.8
Contact person
Contact person’s
phone number
in case of emergency
Section 4: Other information
4.1
Have you ever
visited China before? If ‘Yes’, please
specify date
places and purpose of the
,
recent visit.
4.2
12
Have you ever visited other countries or
territories in the last 12 months? If
‘yes’, please specify date, name of
countries or territories and purpose of
the visits.
4.3
Yes
No
Have you ever overstayed your visa or residence permit in China?
4.4
,
Yes
No
Have you ever been refused a visa for China, or been refused entry into China?
4.5
Yes
No
Do you have any criminal record in China or any other country?
4.6
Are you affiliated with any of the following diseases?
Serious mental disorder
Yes
No
Infectious pulmonary tuberculosis
Other infectious disease of public health hazards
4.7
30
Yes
No
Did you visit countries or territories infected by infectious diseases in the last 30 days?
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