APPLICATION FOR SCHENGEN VISA
This application form is free.
Photo
Mother’s name
12Stamp of Embassy or Consulate
Supporting documents:
For Embassy/
Consulate u only
Date application:
File handled by:
Type of passport
13Surname(s) (family name(s))
Surname(s) at birth (earlier family name(s))1First names (given names)23Da马雪阳
te of birth (year-month-day)4Place and country of birth 6ID-number (optional)
5
Current nationality/ies 7Original nationality (nationality of birth)8
Sex
9
Marital status
10Father’s name
11Number of passport 14Date of issue
16If you reside in a country other than your country of origin, have you permission to return to that country?
18No
Refud Visa:
Granted
Service passport
Diplomatic passport National passport Travel document (1951 Convention)
Alien’s passport
Seaman’s passport
Other travel document (plea specify):
Yes (number and validity)
Characteristics of Visa:
Other:
LTV VTL
A B C
D D + C 1Number of entries
2
Multiple Valid from
to
Valid for
Valid until
17Male Female
E C 109
Single Divorced
Separated Other
Married Widow(er)
Issued by 15Current occupation
19*
Employer and employer’s address and telephone number. For小要
students, name and address of school.
20*
Main destination 21Type of visa
22Airp民间二胡
ort transit Transit
Short stay Long stay
Visa
23Individual logo尺寸
Collective
Number of entries requested
24Duration of stay
25Visa is requested for:
Single entry
Two entries
Multiple entries
days
Other visas (issued during the past three years) and their period of validity 26In the ca of transit, have you an entry permit for the final country of destination?
27No
Yes, valid until:
Issuing authority:
Previous stays in this or other Schengen States
28*
* The question marked with * do not have to be answered by family members of EU or EEA citizens (spou, child or
dependent ascendant). Family members of EU or EEA citizens have to prent documents to prove this relationship.
Health insurance Means of transport Invitation
Financial means Valid passport:
For Embassy/
Consulate u only
Purpo of travel
Date of arrival
29Border of first entry or transit route
30*
32*
Name of host or company in the Schengen States and contact person in host company.If not applicable, give name of hotel or temporary address in the Schengen States
34*Name
Date of departure
31*
Full address
Tourism
Other (plea specify):
Who is paying for your costs of travelling and for 殆尽的意思
your costs of living during your stay?
35*
Mylf * The question marked with * do not have to be answered by family members of EU or EEA citizens (spou, child or dependent ascendant). Family members of EU or EEA citizens have to prent documents to prove this relationship.
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ness
Visit to Family or Friends
Cultural/Sports
Official
Medical reasons
Means of transport
33*
Telephone and telefax E-mail address
Host person/s Host company (State who and how and prent corresponding documentation):
Means of support during your stay
36*
Cash Traveller’s cheques Credit cards Accommodation Other:
Travel and/or health i燕窝好处
nsurance. Valid until:
Spou’s family name 37Spou’s famil第一次包饺子
y name at birth
38Spou’s first name
39Spou’s date of birth
40Spou’s place of birth
41Children (Applications must be submitted parately for each passport)
42Name
First name
Date of birth
123
Personal data of the EU or EEA citizen you depend on.
This question should be answered only by family members of EU or EEA citizens.
43Name First name
Date of birth
Nationality
Number of passport
Family relationship: (of an EU or EEA citizen)
I am aware of and connt to the following: any personal data concerning me which appear on this visa application
form will be supplied to the relevant authorities in the Schengen States and procesd by tho authorities, if necessary, for the purpos of a decision on my visa application. Such data may be input into, and stored in,databas accessible to the relevant authorities in the various Schengen States.
At my express request, the consular authority processing my application will inform me of the manner in which I may exerci my right to check the personal data concerning me and have them altered or deleted, in particular,should they be inaccurate, in accordance with the national law of the State co暑假的一天
ncerned.
I declare that to the best of my knowledge all particulars supplied by me are correct and complete.
I am aware that any fal statements will lead to my application being rejected or to the annulment of a visa already granted and may also render me liable to procution under the law of the Schengen State which deals with the application.
I undertake to leave the territory of the Schengen States upon the expiry of the visa, if granted.
I have been informed that posssion of a visa is only one of the prerequisites for entry into the European territory of the Schengen States. The mere fact that a visa has been granted to me does not mean that I will be entitled to compensation if I fail to comply with the relevant provisions of Article 5.1 of the Schengen Implementing Convention and am thus refud entry. The prerequisites for entry will be checked again on entry into the European territory of the Schen鬼哭狼嚎
gen States.
44Applicant’s home address 45Telephone number 46Place and date
47Signature (for minors, signature of custodian/guardian)
48
