Form V.2013 - Visa Application Form Of The People'S Republic Of China Page 7
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112. 2. 2. 2.5 5 5 5 预计行程中单次在华停留的最长天数
Days
Days
Days
Days
L L L L ongest
ongest
ongest
ongest i i i i ntended
ntended
ntended
ntended s s s s tay
tay
tay
tay in in in in China
China
China
China among
among
among
among all
all all all entries
entries
entries
entries
日期 Date
详细地址 Detailed
Date
Date
Date
Detailed
Detailed
Detailed address
address
address
address
2. 2. 2. 2.6 6 6 6 在中国境内行
程（按时间顺序, , , ,
可附另纸填写）
Itinerary
Itinerary
Itinerary
Itinerary in in in in
China
China ( ( ( ( in in in in tim
tim
time e e e
China
China
tim
sequence
sequence
sequence
sequence，may
may
may
may
type
type
type on on on on separate
separate
separate
type
separate
paper
paper
paper
paper) ) ) )
2. 2. 2. 2.7 7 7 7 谁 将 承 担 在 中 国 期 间 的 费 用 ？ Who
Who
Who
Who will
will
will
will pay
pay
pay
pay for
for
for
for your
your
your
your travel
travel
travel
travel and
and
and
and
expenses
expenses
during
during
your
your
stay
stay
stay in in in in China?
China?
China?
expenses
expenses during
during your
your stay
China?
姓名或名称
Name
Name
Name
Name
地址
2.8 中国境内邀请
2.8
2.8
2.8
Address
Address
Address
Address
单位或个人信息
Information
Information
Information
Information of of of of
联系电话
inviter
inviter
inviter in in in in China
China
China
inviter
China
Phone
Phone
Phone
Phone number
number
number
number
与申请人关系
Relationship
Relationship
Relationship
Relationship with
with
with
with the
the
the
the applicant
applicant
applicant
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
Have
Have
you
you
ever
ever
been
been
granted
granted
granted a a a a Chinese
Chinese
Chinese
visa?
visa?
visa? If If If If applicable,
applicable,
applicable,
plea
plea
please se se se
Have you
you ever
ever been
been granted
Chinese visa?
applicable, plea
specify
specify
specify
specify the
the
the
the date
date
date
date and
and
and
and place
place
place
place of of of of the
the
the
the last
last
last
last time
time
time
time you
you
you
you were
were
were
were granted
granted
granted
granted the
the
the
the visa.
visa.
visa.
visa.
2.10 过去 12 个月中访问的其他国家或地区 O O O O ther
ther
ther
ther countries
countries
countries
countries or or or or territories
territories
territories
territories
you
you
visited
visited
visited in in in in the
the
the
last
last
last 12 12 12 12 months
months
months
you
you visited
the last
months
三、其他事项 Part
Part
Part
Part 3 3 3 3 : : : : Other
Other
Other
Information
Information
Other Information
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
Have
Have
Have you
you
you
you ever
ever
ever
ever overstayed
overstayed
overstayed
overstayed your
your
your
your visa
visa
visa
visa or or or or
□是 Yes
□否 No
Yes
Yes
No
No
Yes
No
residence
residence
residence
residence permit
permit
permit
permit in in in in China?
China?
China?
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
Have
Have
you
you
ever
ever
been
been
refused
refused
refused a a a a visa
visa
visa
for
for
China,
China,
China, o o o o r r r r
Have you
you ever
ever been
been refused
visa for
for China,
□是 Yes
□否 No
Yes
No
Yes
Yes
No
No
been
been
been
been refused
refused
refused
refused entry
entry
entry
entry into
into
into
into China?
China?
China?
China?
3.3 是 否 在 中 国 或 其 他 国 家 有 犯 罪 记 录 ？ Do
Do
Do
Do you
you
you
you have
have
have
have any
any
any
any criminal
criminal
criminal
criminal record
record
record
record in in in in China
China
China
China or or or or any
any
any
any other
other
other
other
□是 Yes
□否 No
Yes
Yes
Yes
No
No
No
country?
country?
country?
country?
3.4 是否具有以下任一种情形 Are
Are
Are
Are you
you
you
you experiencing
experiencing
experiencing
experiencing any
any
any
any of of of of the
the
the
the following
following
following
following conditions
conditions
conditions
conditions? ? ? ?
①严重精神障碍 Serious
Serious
Serious
Serious m m m m ental
ental
ental
ental d d d d is is is isorder
order
order
order
□是 Yes
□否 No
Yes
Yes
Yes
No
No
No
②传染性肺结核病 Infectious
Infectious
Infectious
pulmonary
pulmonary
pulmonary t t t t uberculosis
uberculosis
uberculosis
Infectious pulmonary
uberculosis
③可能危害公共卫生的其他传染病 Other
Other
Other
Other infectious
infectious
infectious
infectious disease
disease
disease
disease of of of of public
public
public
public health
health
health
health hazards
hazards
hazards
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
Did
Did
Did you
you
you
you visit
visit
visit
visit countries
countries
countries
countries or or or or territories
territories
territories
territories affected
affected
affected
affected
□是 Yes
□否 No
Yes
Yes
No
No
Yes
No
by by by by infectious
infectious
infectious
diseases
diseases
diseases in in in in the
the
the
last
last
last 30 30 30 30 days?
days?
days?
infectious diseases
the last
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 answered "no" to all questions, fill in "N/A."
If If If If you
you
you
you select
select
select
select Yes
Yes
Yes
Yes to to to to any
any
any
any questions
questions
questions
questions from
from
from
from 3 3 3 3 . . . . 1 1 1 1 to to to to 3 3 3 3 . . . . 5 5 5 5 , , , , p p p p lease
lease
lease
lease give
give
give
give detail
detail
detail
details s s s below
below
below
below. . . .
N/A
第 第 第 第 3 3 3 3 页 页 页 页 共 共 共 共 4 4 4 4 页 页 页 页 / Page
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