Form N1 - Application For A Vietnamese Visa Page 2
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214- Proposed date of entry:...................................; Proposed length of stay in Viet Nam................ days
15- Purpose of entry: ...............................................................................................................................
16- Proposed temporary address in Viet Nam:.........................................................................................
17- Hosting organization or individual in Viet Nam (if any):
- Name of hosting organization:............................................................................................................
Address: .............................................................................................................................................
- Hosting individual (full name):...........................................................................................................
Address.................................................................................................................................................
Relationship to the applicant...............................................................................................................
18- Accompanying child(ren) under 14 years old (if any):
Photo
Photo
in 4x6 cm
in 4x6 cm
(under 14 years
(under 14 years
old)
old)
(1)
(1)
See note
See note
Items
Full name
Date of birth
Nationality
Passport
Relationship to
number
the applicant
19- Entries requested:
Single
Multiple
20- Other requests (if any):.......................................................................................................................
I swear that the above declarations are true and correct to the best of my knowledge and belief.
Done at
date (day, month, year)
Signature and full name of the applicant
Note:
(1) Each applicant completes one form, stick a recent (4x6) photo on a white background, straight looking, without hat or sunglasses.
(2) If document is a passport, please specify its type: Ordinary, Official/Service or Diplomatic; for document in lieu of
passport, please specify its name.
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