EMBASSY OF NEPAL
Bangkok, Thailand
Recent Photograph
(Please paste)
VISA APPLICATION FORM
2” x 2” Inches
1. Full Name:
Mr/Mrs/Miss _________________________________________________________________________
(IN BLOCK, AS IN THE PASSPORT)
2. Nationality: _________________________ 3. Occupation: ____________________________________
4. A. Address in Thailand: ________________________________________________________________
B. Permanent Address: ________________________________________________________________
C. Telephone: ___________________________Email:______________________________________
D. Contact number in case of emergency: __________________________________________________
5. Date of Birth: __________________________
6. Place of Birth: __________________________
7. Passport No: __________________________
8. Place of Issue: __________________________
9. Date of Issue: __________________________
10. Date of Expiry: _________________________
11. Expected Date of Arrival in Nepal: ____________________
12. Period of Stay in Nepal: _______________________Day(s).
13. Address in Nepal: _____________________________________________________________________
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14. Purpose of Visit:
Official
Tourism
Business
Others
___________________
(Please specify)
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15. Visa applied for:
15 Days
30 Days
90 Days
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16. Have you visited Nepal before:
yes
No
If yes:
A) Date of your last visit: _____________________________________
B) No. of days you have stayed in Nepal this year___________________
17. Person(s) accompanying (if any):
Full Name
Date of Birth
Place of Birth
A. _____________________________________
___________
__________________
B. ______________________________________
___________
__________________
_______________
___________________
Date
Signature of Applicant
(Please attach a copy of the Bio data page of your passport with this form)
FOR OFFICIAL USE ONLY
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Category of Visa:
Official
Tourist
Transit
Others
Serial & Sticker No.: __________________
Visa Fee: THB _______________
__________________
_________________
Date
Authorized Signature