VIETNAM WASHINGTON D.C VISA APPLICANT FORM

Vietnam Visa Applicant form for Washington D.C.

1. Name (in block letters):
………………………………………………………………………………………………………………….
Family name First name Middle name
2. Date of birth:………………./…………./….… …
Date / Month / Year
3. Male:  Female 
4. Place of birth:……………………………………….
5. Nationality at birth:………………………………..
Nationality at present:…………………………….
6. Passport number:………………………………….
Date of issue:……………. ……….. ……….. ………
Date of expiry:……….. ……….. ……….. ………..
7. Profession:………………………………………………
Place of employment:……………………………….
……………………………… ……………………. ….
……….…………………………………………
Telephone (Office):…….…………………….. …..
8. Present mailing address: (P.O Box Not
Accepted)
………….………………………………………
…………………………………………………
…………………………………………………
…………………………………………………
Telephone (Home):…………………………………
9. Purpose of visit to Vietnam:
…………………………………………………
…………………………………………………
…………………………………………………
10. Name, address of your contact (sponsor, host,
hotel…) in Vietnam (if any)
…………………………………………………………
……………………………………………………….……
……………………………………………………………….
……………………………………………………………….
……………………………………………………………….
..………………………………………….…
11. Proposed date of entry:
………. …./……………/……… …..
Date / Month / Year
Proposed date of exit:
….… … /…………/…………..
Date / Month / Year
12. Requesting a visa good for:
••• Times of entries:
– Single (one time) visit 
– Multiple visits 
••• Length of stay:
– One month 
– 03 months 
– Less than 6 Months (with an approval only) 
– Up to one year (with an approval only) 

I solemnly declare that the statements made in this application are true and correct.
Date:…………………………………………………
Signature of Applicant ………………………………………..
Check list: Before submitting, make sure you have included:
 Original Passport (for a visa sticker request); or  Passport copy (front photo page, for a loose-leaf visa request)
 Completed and signed Application with One Photo glued or stapled;
 Visa Fee: Money Order (or Cashier’s Check); and
 Prepaid USPS Express Mail or FedEx Slip, (if you want your visa be returned by mail).

———————————————————————————————————————————————————————-

With any further questions or concerns please contact our own “Visa Knowledge Champion”

Cynthia Barnes:
202.298.6550
CBarnes@documentlegalization.us

Document Legalization.US

is a partner of ProEx Corp.

www.goproex.com

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