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申请表格

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Application for Schengen Visa申根国家签证申请表This application form is free此表免费This application form must be filled out in Dutch or in English此表格必须用荷兰语或英语填写
1. Surname(s) (family name(s)) 姓For embassy consulate use only仅供使领馆使用
2. Surname(s) at birth (earlier family name(s)) 出生时姓(原姓)
Date application :
3. First names (given names) 名
4. Date of birth 出生日期
5. ID-number (optional)身份证号码(如有则填)
File handled by :
6. Place and country of birth出生地及国家Supporting documents:
7. Current nationalityies现国籍
8. Original nationality (nationality at birth)原国籍Valid means
9. Sex 性别Male 男Female女
10. Marital status : 婚姻状况Single未婚Married已婚Separated分居Divorced离婚Widow(er)丧偶Other其它 of insurance
Other :
of Visa :
11. Fathers name父亲姓名
12. Mothers name母亲姓名LTVABCDDC
13. Type of passport:护照类型:
National passport私人护照Diplomatic passport 外交护照Service passport公务护照Travel document (1951 Convention)旅行证件(1951年公约)
Aliens passport外国人护照Seamans passport海员护照Other travel document (please specify): 其它旅行证件(请注明
Number of entries :
12 Multiple
14. Number of passport护照号码:
15. Issued by发照机关:Valid fromTo
16. Date of issue发照日期:
17. Valid until有效期至:
Valid for :
18. If you reside inacountry other than your country of origin, have you permission to return to that country 如果你的居住国不是你的国籍所在国,你是否被允许返回居住国( No 不是( Yes, (number and validity)是,(号码和有效期至)
19. Current occupation现职业
Visa :
20. Employer and employers address and telephone number. For students, name and address of school.工作单位名称,地址和电话、学生填写学校名称及地址
21. Main destination主要目的地
22. Type of Visa :签证类型Airport transit机场过境Transit 过境Short stay短期停留Long stay长期停留
23. Visa : 签证Individual个人签证Collective团体签证
24. Number of entries requested申请入境次数Single entry一次入境Two entries两次入境Multiple entries多次入境
25. Duration of stay 停留时间申请______ 天签证:
26. Other visas (issued during the past three years) and their period of validity其它签证(最近三年内)及有效期至:
27. In the case of transit, have you an entry permit for the final country of destination 如需过境、你是否有进入最终目的国家的入境许可No没有Yes , valid until: 有、有效期至: Issuing authority:签发机关:
28. Previous stays in this or other Schengen states以前在本申根国或其它申根国停留情况:
The questions marked with do not have to be answered by family members of EU or EEA citizens (spouse, child or dependent ascendant). Family members of EU or EEA citizens have to present documents to prove this relationship. 欧盟或欧洲经济区公民的家庭成员(配偶,子女或赡养的老人)不必回答带的问题,欧盟或欧洲经济区公民的家庭成员必须提交证明其亲属关系的文件.
29. Purpose of travel旅行目的Tourism 旅游Business商务Visit to Family or Friends探亲访友CulturalSports文化体育Official 官方访问Medical reasons医疗Other (please specify): 其它:(请详细注明
30. Date of arrival抵达日期
31. Date of departure离境日期
32. Border of first entry or transit route第一入境国或过境路线
33. Means of transport交通工具
34. 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申根国的邀请人或公司名称及该公司的联系人、如不适用,请填写申根国的旅馆名或暂住地址Name姓名Telephone and telefax电话及传真号Full address详细地址e-mail address电子邮件
35. Who is paying for your cost of travelling and for your costs of living during your stay 谁支付你的旅行费用以及在国外停留期间的生活费用Myself申请人Host persons邀请人Host company. (State who and how and present corresponding 邀请公司(请注明何人和如何支付,并出示相关材料)
36. Means of support during your stay在国外停留期间的费用支付方式:
Cash现金Travellers cheques旅行支票Credit cards信用卡Accommodation有住房Other:其它:
Travel andor health insurance. Valid until: 旅行或医疗保险有效期至:
37. Spouses family name配偶姓
38. Spouses family name at birth配偶原姓
39. Spouses first name配偶名
40. Spouses date of birth配偶出生日期:
41. Spouses place of birth配偶出生地:
42. Children (Applications must be submitted separately for each passport)子女(持单独护照的子女必须分别递交申请)Name 姓First name名Date of birth出生日期
3
43. 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. 凡涉及您依靠的欧盟或欧洲经济区公民的个人资料,仅需与欧盟或欧洲经济区公民有亲属关系的申请人填写:Name 姓First Name名Date of Birth出生日期Nationality国籍Number of passport护照号码Family relationship : 与欧盟或欧洲经济区公民的亲属关系:of an EU or EEA citizen
44.Iam aware of and consent 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 processed by those authorities, if necessary, for the purposes ofadecision on my visa application. Such data may be input into, and stored in, databases 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 whichImay exercise 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 concerned.
I declare that to the best of my knowledge all particulars supplied by me are correct and complete.
I am aware that any false statements will lead to my application being rejected or to the annulment ofavisa already granted and may also render me liable to prosecution 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 possession ofavisa is only one of the prerequisites for entry into the European territory of the Schengen states. The mere fact thatavisa has been granted to me does not mean thatIwill be entitled to compensation ifIfail to comply with the relevant provisions of Article 5.1 of the Schengen Implementing Convention and am thus refused entry. The prerequisites for entry will be checked again on entry into the European territory of the Schengen states.
我知道并同意以下条款:本签证申请表上关于我的任何个人资料,将被提交给有关申根国家的相应机构,以便用于审理我的签证申请.此资料可以被输入并存储在申根国家的相关机构的数据库中、并由各申根国家的有关机构使用.
如我明确请求,对我的申请进行审理的使领馆应通知我,以何种方式可以行使核查有关我的个人资料并依据有关国家法律规定更改或消除错误数据的权利.
我声明,就我所知,我提供的一切资料都是正确和完整的.我知道,任何虚假陈述都将导致拒绝签证或已发签证的废止,也可以根据对我的申请进行审理的申根国家的法律规定进行刑事追究.
如果签证申请被批准,我保证在签证到期时离开申根国家领土.我获悉、拥有签证只是进入欧洲申根国家领土其中的一个条件,如果没有履行申请执行公约第五条第一款规定的条件而被拒绝入境、那么仅仅拥有签证并不意味着我有权就此要求赔偿.在进入欧洲申根国家的领土时,入境条件将被再次审查.
45. Applicants home address 申请人家庭地址
46. Telephone number 电话号码
47. Place and date 申请地点和日期
48. Signature (for minors, signature of 签名(未成年人由其监护人代签 DGHI ENPhoto照片

doc文档的标签：表格申请

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