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1、APPLICATION FOR SCHENGEN VISA This application form is free. Photo Mothers name12 Stamp of Embassy or Consulate Supporting documents: For Embassy/ Consulate use only Date application: File handled by: Type of passport13 Surname(s) (family name(s) Surname(s) at birth (earlier family name(s) 1 First n
2、ames (given names) 2 3 Date of birth (year-month-day)4 Place and country of birth6 ID-number (optional)5 Current nationality/ies7Original nationality (nationality of birth)8 Sex9Marital status10 Fathers name11 Number of passport14 Date of issue16 If you reside in a country other than your country of
3、 origin, have you permission to return to that country?18 No Refused Visa: Granted Service passportDiplomatic passportNational passportTravel document (1951 Convention) Aliens passportSeamans passportOther travel document (please specify): Yes (number and validity) Characteristics of Visa: Other: LT
4、V VTL A B C D D + C 1 Number of entries 2 Multiple Valid from to Valid for Valid until17 Male Female EC 109 Single Divorced Separated Other Married Widow(er) Issued by15 Current occupation19 * Employer and employers address and telephone number. For students, name and address of school.20 * Main des
5、tination21Type of visa22 Airport transit Transit Short stay Long stay Visa23 Individual Collective Number of entries requested24Duration of stay25 Visa is requested for:Single entryTwo entriesMultiple entriesdays Other visas (issued during the past three years) and their period of validity26 In the
6、case of transit, have you an entry permit for the final country of destination?27 No Yes, valid until:Issuing authority: Previous stays in this or other Schengen States28 * * The question marked with * do not have to be answered by family members of EU or EEA citizens (spouse, child or dependent asc
7、endant). Family members of EU or EEA citizens have to present documents to prove this relationship. Health insurance Means of transport Invitation Financial means Valid passport: PDF InstructionReset Next Page For Embassy/ Consulate use only Purpose of travel Date of arrival 29 Border of first entry
8、 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 departure31 * Full address Tourism Other (please specify): Who is paying for your costs o
9、f travelling and for your costs of living during your stay?35 * Myself * The question 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. Bu
10、siness Visit to Family or Friends Cultural/SportsOfficialMedical reasons Means of transport33 * Telephone and telefax E-mail address Host person/sHost company (State who and how and present corresponding documentation): Means of support during your stay36 * CashTravellers chequesCredit cardsAccommod
11、ationOther: Travel and/or health insurance. Valid until: Spouses family name37Spouses family name at birth38 Spouses first name39Spouses date of birth40Spouses place of birth41 Children (Applications must be submitted separately for each passport)42 NameFirst nameDate of birth 1 2 3 Personal data of
12、 the EU or EEA citizen you depend on. This question should be answered only by family members of EU or EEA citizens. 43 NameFirst nameDate of birth NationalityNumber of passport Family relationship: (of an EU or EEA citizen) I am aware of and consent to the following: any personal data concerning me
13、 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 of a decision on my visa application. Such data may be input into, and stored in, databases accessible to the relevant au
14、thorities 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 exercise my right to check the personal data concerning me and have them altered or deleted, in particular, should they be inaccurate, in acco
15、rdance 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 of a visa already granted and may also render m
16、e 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 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
