1. Name and surname (in block letters) ………………………………………………………………………………………………
2. Date of birth ……../……../ ………….
dd mm yy
3. Male/Female ………
4. Place of birth…………………………………..
5. Nationality at birth…………………………….
Nationality at present…………………………
6. Passport number……………………………..…
issued by……………………………………….
Date of issue……….Date of expiry…………..
7. Profession……………………………………….
Place of employment…………………………..
Office telephone number………………………..
8. Present address………………………………..
……………………………………………..….
Home telephone number………………………..
________________________________
Please submit the following documents:
1. One copy of application form with one passport photo
2. Original passport
3. Visa fee (Please call visa section for current fees)
4. If apply by mail, pls. enclose a prepaid self-addressed
return envelope and retain one copy of the application
form for enquiry about visa status
9. Purpose of visit to Vietnam………………………..
10. Name, address of your contact (office,
organization or individual) in Vietnam (leave it blank
if you apply for tourist visa)
……………………………………………………………………………
……………………………………………………………………………
…………………………………………………………………………
11. Proposed date of entry into and exit from Vietnam
from ………./………./………to ………../………/………
dd mm yy dd mm yy
12. Number of entries: Single…….. multi……..
I solemnly declare that the statements made in this
application are true and correct.
Date and place of application ……………………………….
………………………………….
Signature
Official use only
Fax:
Date of fax:
Visa:
———————————————————————————————————————————————————————-
With any further questions or concerns please contact our own “Visa Knowledge Champion”
Cynthia Barnes:
202.298.6550
CBarnes@documentlegalization.us
document legalization 