Form V.2013 - Visa Application Form Of The People'S Republic Of China (For The Mainland Of China Only) Page 6

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2.5 预计行程中单次在华停留的最长天数
p. 6
Days
Longest intended stay in China among all entries
日期 Date
详细地址 Detailed address
2.6 在中国境内行
程(按时间顺序,
可附另纸填写)
Itinerary in
China (in time
sequence,may
type on separate
paper)
2.7 谁将承担在中国期间的费用?Who will pay for
PREPAID TOUR WITH VIKING CRUISES
your travel and expenses during your stay in China?
姓名或名称
NONE - PREPAID TOUR WITH VIKING CRUISES
Name
地址
2.8 中国境内邀请
Address
单位或个人信息
联系电话
Information of
inviter in China
Phone number
与申请人关系
Relationship with the applicant
2.9 是否曾经获得过中国签证?如有,请说明最近一次获得中国签证的时
间和地点。Have you ever been granted a Chinese visa? If applicable,
please specify the date and place of the last time you were granted the visa.
2.10 过去 12 个月中访问的其他国家或地区 Other countries or territories
you visited in the last 12 months
三、其他事项 Part 3: Other Information
3.1 是否曾在中国超过签证或居留许可允许的期限停留?Have you ever overstayed your visa or
□是 Yes
□否 No
residence permit in China?
3.2 是否曾经被拒绝签发中国签证,或被拒绝进入中国?Have you ever been refused a visa for China, or
□是 Yes
□否 No
been refused entry into China?
3.3 是否在中国或其他国家有犯罪记录?Do you have any criminal record in China or any other
□是 Yes
□否 No
country?
3.4 是否具有以下任一种情形 Are you experiencing any of the following conditions?
严重精神障碍 Serious mental disorder
□是 Yes
□否 No
传染性肺结核病 Infectious pulmonary tuberculosis
可能危害公共卫生的其他传染病 Other infectious disease of public health hazards
3.5 近 30 日内是否前往过流行性疾病传染的国家或地区?Did you visit countries or territories affected
□是 Yes
□否 No
by infectious diseases in the last 30 days?
3.6 如果对 3.1 到 3.5 的任何一个问题选择“是” ,请在下面详细说明。
If you select Yes to any questions from 3.1 to 3.5, please give details below.
N/A
12/5
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