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1、Tel: 电话Notes:* Tick () where appropriate请在适用处打勾 ()签证申请表格 (请用英语填写) FORM 14AIMMIGRATION ACT CHAPTER 133, SECTION 55(1)PART I PARTICULARS OF APPLICANT 申请者信息Name:Name as in Travel Document 姓名 (根据旅游证件格式, 用英文填写）Alias （别名）Date of Birth:D D （日） M M （月） Y Y Y Y （年）Sex:*性别Male 男Female 女Marital Status:*SingleM
2、arriedSeparatedDivorcedWidowed婚姻状况单身已婚分居离婚丧偶Country of Birth:出生国家State/Province of Birth:出生省份Race: (e.g. Malay, Indian, Chinese, Caucasian, etc)种族 （如 马来人、印度人、华人、欧亚人等）Nationality:国籍Type of Travel Document Held: 所持旅游证件种类 (如：护照、身份证书、临时身份证明等)(e.g. Passport, Certificate of Identity, Document of Identity,
3、 etc)Travel Document No.:旅游证件号码Travel DocumentIssued Date:Expiry Date:旅游证件签发日期D D （日） M M （月） Y Y Y Y （年）有效期至D D （日） M M （月） Y Y Y Y （年）Country of Issue:签发国家Place of Issue:签发地点PASSPORTS ACT No. 33 of 2007 APPLICATION FOR AN ENTRY VISA （申请入境签证）Affix a recent Passport-size photograph here贴上近期 护照照片一张IM
4、M 14A- 2 -THIS FORM IS ISSUED FREE 此表免费分发 (只限用于中国国内)Address in Country of Origin 所属国家地址Country of Origin:所属国家Division/State/Province of Origin:所属省份Prefecture of Origin所属城市County/District of Origin所属县/区Address : 地址PART II OTHER DETAILS 其他信息Occupation:职业Highest Academic/Professional Qualifications Att
5、ained: 最高学历Religion/Denomination: 宗教信仰/宗派Purpose of visit : 到访目的Date of Intended Arrival in Singapore / Period of Visa Applied For: 预计到访新加坡的日期/欲申请签证的期限How long do you intend to stay in Singapore ?*Up to 30 daysMore than 30 days您预计在新加坡居留多久？最多 30 天超过 30 天If your intended stay in Singapore is more than
6、 30 days, please state the reason for your intended length of stay and the duration. 若您预计将在新加坡居留超过 30 天，请说明理由并注明您将居留的期限。Nationality of Spouse:*Singapore CitizenSingapore Permanent Resident配偶国籍新加坡公民Others (Please Specify)新加坡永久居民其他（请注明）Address in Singapore 在新加坡的地址Where will you be staying in Singapore
7、 ?*您将在新加坡何处住宿？Next-of-kins PlaceRelatives PlaceFriends PlaceHotelOthers (Please Specify) 直系亲属处亲戚处朋友处酒店其他 （请注明）Block/House No.（楼号）:Floor No. （楼层）:Unit No.（门号）:Postal Code（邮编）:Street Name:Tel No: 街道名字电话号码Building Name: 大楼名称Did you reside in other countries, other than your country of origin, for one y
8、ear or more during the last 5 years ?*您是否在过去5年内，除了在您所属国家外，在其他国家居留一年或以上？Yes 是No 否If yes, please furnish details 若是，请提供相关详情Period of Stay 居留日期Country 国家Address 地址From 从To 至PART III ANTECEDENT OF APPLICANT * 申请人申请背景(a) Have you ever been refused entry into or deported from any country, including Singap
9、ore?您是否曾被任何国家（包括新加坡）拒绝入境或遣返回国？(b) Have you ever been convicted in a court of law in any country, including Singapore?您是否曾在任何国家（包括新加坡）的法律下被宣判有罪？(c) Have you ever been prohibited from entering Singapore?您是否曾被禁止进入新加坡？(d) Have you ever entered Singapore using a different passport or name?Yes 是 Yes 是 Yes
10、 是Yes 是No 否 No 否 No 否No 否您是否曾用其他名字或护照进入新加坡？If any of the answer is “YES”, please furnish details on a separate sheet of paper. 若以上任何一个问题答案为“是”，请用另一页纸提供详情。PART IV - DECLARATION BY APPLICANT （申请人宣誓）I declare that the particulars and documents furnished in respect of this application are true and corre
11、ct.本人谨此声明,本人在这份申请书里所提供的一切资料均属实与正确。I undertake not to misuse controlled drugs or to take part in any political or other activities during my stay in Singapore which would make me an undesirable or prohibited immigrant under the Immigration Act.本人保证在居留新加坡期间不滥用受管制药物,或参加任何政治性活动或其他足以使本人成为在移民法令下不受欢迎或被禁入境人
12、士的活动。I undertake to comply with the provisions of the Immigration Act and any regulations made thereunder or any statutory modification or re-enactment thereof for the time being in force in Singapore.本人保证遵守移民法令的规定以及该法令下的任何条列,或新加坡现行的对该法令所作的任何法定修改或重新制定。I undertake not to involve in any criminal offen
13、ces in Singapore.本人保证在新加坡期间不涉及任何刑事罪行。I undertake not to indulge in any activities which are inconsistent with the purpose for which the immigration passes have been issued本人保证不沉溺于任何不符合贵局签发移民证件原意的活动。I further undertake not to be engaged in any form of employment, business or occupation whilst in Sing
14、apore without a valid work pass issued under theEmployment of Foreign Manpower Act ( Cap. 91A ).本人进一步保证在居留新加坡期间,在没持有外国劳工雇佣法令签发的工作准证的情况下,不参与任何形式的就业,商业或职业。I am aware that overstaying or working illegally in Singapore is a serious offence and on conviction, the penalties may include mandatory imprisonment and caning.本人知道,在新加坡逾期居留或非法工作是很严重的罪行,而且罪名成立时的惩罚可能包括强制性监禁和鞭刑。I understand that if the Controller of Immigration is satisfied that I or any member of my family b
