Vietnam VISA Application Form (doc)

Vietnam VISA Application Form - For more information please visit http://www.vietnamembassy-usa.org

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VISA 01 Photo EMBASSY OF VIETNAM APPLICATION (2 inches x 2 inches, 1233 20th Street, NW, Suite 400 bright background) Washington, D.C. 20036 (FOR NON-VIETNAMESE Glue or staple PASSPORT HOLDERS) photo here Tel: (202) 861-0737, (202) 861-2293 ______ Fax: (202) 861-0917 http://www.vietnamembassy.us 1. Name (in block letters): ................................................................................. …………………………………………. Family name First name Middle name 2. Date of birth:..................................….………… 9. Purpose of visit to dd mm yy Vietnam: .......................................................... 3. Male:  Female  ........................................................................... 4. Place of birth:....................................................... ................. 5. Nationality at birth:.............................................. 10. Name, address of your contact in Vietnam: Nationality at present:........................................... (organization or individual) 6. Passport number:.................................................. ................................................……………… Date of issue:..................Date of expiry:...........… ................................................................…… 7. Profession:............................................................. ........................................................................... Place of employment:........................................... .....………………………………………….… Telephone (Office):…....….................................. 11. Proposed date of entry and exit Vietnam: 8. Present address: (P.O Box Not Accepted) from.........../........../......... to....…./….…/……... ………….………………………………………….…. dd mm yy dd mm yy ………………………………………………………... Telephone (Home):............................................ 12. Number of entries: Single  Multiple  I solemnly declare that the statements made in this application are true and correct. City, State:…………………………………………………… Date:……………………………………………………………… Signature: ....................................................................................…. Before submitting, make sure you have included:  Original Passport;  Completed and signed Application with One Photo glued or stapled;  Visa Fee: Money Order (or Cashier’s Check); and  Prepaid US Express Mail Slip (UPS and DHL are not accepted for the return envelope), (if you want your visa be returned by mail). Last Update: November 2006