中 华 人 民 共 和 国 签 证 申 请 表Visa Application Form of the People’s Republic of China
申请人必须如实、完整、清楚地填写本表格。请逐项在空白处用中文或英文大写字母打印填写，
或在□内打√。如有关项目不适用，请写“无”。

照片/Photo（必填／Ｒｅｑｕｉｒｅｄ＊）

The applicant should fill in this form truthfully, completely and clearly. Please type the answers in Chinese or
English capital letters in the space provided or tick (√) the relevant box to select. If some of the items do not apply,
please type N/A or None.

一、个人信息 Personal Information

1.1 姓名/Name

1.1A 姓/ Family name： （必填／Ｒｅｑｕｉｒｅｄ＊）

1.1B 名/ Given name(s)： （必填／Ｒｅｑｕｉｒｅｄ＊）

1.1C 别名或曾用名/ Other name(s) or Former name(s)：1.1D 中文姓名（请用中文填写）/ Chinese name (if applicable , inChinese)：
1.3 性别/ Gender： □ 男/ Male □ 女/ Female （必填／Ｒｅｑｕｉｒｅｄ＊）

1.2 出生日期/ Date of birth (yyyy/mm/dd)： （必填／Ｒｅｑｕｉｒｅｄ＊）
1.4A 国家或地区/ Country or region： （必填／Ｒｅｑｕｉｒｅｄ＊）
1.4 出生地点/
Place of birth

1.6
国籍和永久居留/Nationality andpermanent
residence

1.4B 省份/ Province/State： （必填／Ｒｅｑｕｉｒｅｄ＊）□ 离异/ Divorced□ 丧偶/ Widowed

1.4C 城市/ City： （必填／Ｒｅｑｕｉｒｅｄ＊）□ 其他/ Other(Please specify)：

1.6A 现有国籍/ Nationality： （必填／Ｒｅｑｕｉｒｅｄ＊）

1.6F 其他国家（地区）永久居留/Other permanent resident countries
or region：

1.6B 国籍国身份证件号码/ National ID number：

1.6G 曾有国籍/ Former nationality(ies)：（必填／Ｒｅｑｕｉｒｅｄ＊）
1.6C 其他国籍/ Other nationality(ies):

1.6H 如曾有中国国籍，请提供以下信息/Please provide thefollowing information if you have ever held Chinese nationality：

1.6D 其他国籍身份证件号码/ ID number(s) of othernationality(ies):

曾有中国身份证号码/ Former Chinese ID number:

1.6E 其他国籍护照号码/ Passport number(s) of othernationality(ies):

曾持有的最后一本中国护照号码/ Number of your last Chinese
passport：

1.7A 护照/旅行证件种类/ Type of passport/travel document:

1.7C 签发国家或地区/ Issuing country or region:□ 外交/ Diplomatic
1.7
护照信息/
Passport

1.5 婚姻状况/ Marital status： （必填／Ｒｅｑｕｉｒｅｄ＊）□ 已婚/ Married□ 单身/ Single□ 公务/ Service□ 官员/ Official□ 普通/ Ordinary（必填／Ｒｅｑｕｉｒｅｄ＊）

1.7D 签发地点/ Place of issue:□ 特别/ Special（必填／Ｒｅｑｕｉｒｅｄ＊）（必填／Ｒｅｑｕｉｒｅｄ＊）□ 其他证件（请说明）/ Other(Please specify):

1.7E 失效日期/ Expiration date:

1.7B 护照/旅行证件号码/ Passport/travel document number:（必填／Ｒｅｑｕｉｒｅｄ＊）二、申请信息 Type of Visa
2.1 申请签证种类及主要来华事由/ Type of visa and major purpose of your visit to China□（L）旅游/Tourism□（M）
商业贸易活动/Commercial tradeactivities□（F）交流、访问、考察等/
Exchanges, visits,□ A 个人旅游/ Independent tourist□ B 团体旅游/ Group member（必填／Ｒｅｑｕｉｒｅｄ＊）

如选“B”，请填写/If choose B, please provide the following information:
中国境内旅行社名称/Travel Agency in China:
旅行社业务经营许可证编号/Travel Agency License No.:

□ A 贸易活动/ Trade□ B 参加比赛/ Participation in Competition(s)□ C 其他商业活动/ Other commercial activities□ A 学术交流活动/ Academic exchanges□ B 文化交流活动（如交流性演出）/ Cultural exchanges (e.g. a non-profit performance)□ C 宗教交流活动/ Religious exchanges
1/6

study tours or otherrelevant activities□ D 非政府组织交流活动/ NGO activities□ E 志愿者、义工（不超过 90 日）/ Volunteering (no more than 90 days)□ F 持《外国专家来华邀请函》的外国专家/ Foreign expert with pre-approved letters of invitation□ G 地理测绘活动/ Geographic surveying and mapping activities

□

□

□

（Q1、Q2）
中国公民或具有中国
永久居留资格的外国
人的家庭成员或亲属/
Family member or
relative of Chinese
citizen(s) or
foreigner(s) withpermanent residence
status in China（S1、S2）
中国境内停留居留的
外国人的家庭成员或
因其他私人事务需要
在中国境内停留的人
员/
Family member offoreigner(s) staying
or residing in Chinaor person who needs
to come to China for
personal matters

（Z）
工作/
Work

□ A 因家庭团聚申请入境居留的中国公民的家庭成员/ Family member ofChinese citizen applying for residence in China for family reunion□ B 因家庭团聚申请入境居留的具有中国永久居留资格的外国人的家庭
成员/ Family member of foreigner(s) with permanent residence status in
China who is applying for residence in China for a family reunion□ C 因寄养等原因申请入境居留的人员/ Residence visa for child to befostered in China□ D 入境短期探亲（不超过 180 日）的居住在中国境内的中国公民的亲属/ Relative of Chinese citizen(s) living in China applying for a visa for visit
no more than 180 days
□ E 入境短期探亲（不超过 180 日）的具有中国永久居留资格的外国人的
亲属/ Relative of foreigner(s) with permanent residence status in China
applying for a visa for visit no more than 180 days
□ A 入境长期探亲（超过 180 日）的因工作、学习等事由在中国境内居留的外国人的配偶、父母、未满 18 周岁的子女、配偶的父母/ Spouse, parent,child under the age of 18 or parent-in-law of foreigner(s) residing in China
for work, study or other purposes who visit China for more than 180 days
□ B 因其他私人事务需要在中国境内居留的人员/ Person who needs toreside in China for other personal matters□ C 入境短期探亲（不超过 180 日）的因工作、学习等事由在中国境内停
留居留的外国人的家庭成员/ Family member of foreigner(s) staying orresiding in China for work, study or other purposes who visit China for no
more than 180 days
□ D 因其他私人事务（如处理诉讼、继承、医疗事务、打理在华房产等）
需要在中国境内停留的人员/ Applying for a visa to stay in China forother personal matters, such as handling litigation, inheritance, real estate
or medical treatment□ A 入境工作的外国专家/ Foreign expert working in China□ B 营业性演出/ For commercial performance请同时填写如下信息/
Please provide the following information:
中国公民/寄养委托人/具有永久居留资格的外国人
姓名/ Name of the Chinese citizen(s)/Guardian(s)/Foreigner(s) with permanent resident status:
与您的关系/ Relationship(s) to you:身份证或居留证件号码/ ID or permanent residence
permit number(s) :请同时填写如下信息/
Please provide the following information:
被探望人姓名/ Name of the residing foreigner(s):与您的关系/ Relationship to you:
居 留 证 件 号 码 或 签 证 号 码 / Residence permit(s)number or visa number如选 B 或D 项，
请说明事由/ If B or D, please specify
the matters:□ C 外国企业常驻中国代表机构的首席代表、代表/ Chief representative or representative of a foreign company□ D 海上石油作业/ Offshore oil operations□ E 志愿者、义工（超过 90 日）/ Volunteering (more than 90 days)□ F 其他取得中国政府主管部门颁发的工作许可入境工作的人员/ Foreigner working in China with a Work Permit issued by the
Chinese government□（X1、X2）
学习/Study□ A 长期学习（超过 180 日）/ Long term study (more than 180 days)□（J1、J2）
记者/Journalist□ A 入境进行短期采访报道的外国记者/ Foreign journalist visiting China for short-term news coverage□ B 短期学习（不超过 180 日）/ Short term study (no more than 180 days)□ B 外国常驻中国新闻机构的外国常驻记者/ Resident foreign journalist of permanent office of a foreign news agency in China□ A 国际列车乘务员/ Crew member performing duties on board an international train□（C）乘务/ Crew member□ B 国际航空器机组成员/ Crew member performing duties on board an international aircraft□（G）过境/ Transit经中国过境/ Transit through China□（D）永久居留/
Permanent residence

入境永久居留的人员/ Person coming to China to take up permanent residence□□（R）人才/
Foreigner of hightalent or specialist

外交签证/
Diplomatic visa

□ C 国际航行船舶的船员及船员随行家属/ Crew member performing duties on board an international vessel or accompanying
familymember□D从事国际道路运输的汽车驾驶员/
Vehicle driver engaged in international transportation services□ 国家需要的外国高层次人才和急需紧缺专门人才/ Foreigner of high talent or specialist needed by the State
人才引进计划名称/ Name of the talent recruitment programme:□ 持《外国高端人才确认函》人员/ Foreigner with Confirmation Letter for High Level Foreign Talents□ A 应邀入境访问的外国国家元首、政府首脑、外交部长以及其他具有同等身份的官员及随行配偶、未成年子女/ Head of state or
government, foreign minister or other official with equivalent rank invited for an official visit and accompanying spouse and/or
child(ren) under the age of 18□ B 持外交护照或相应国际旅行证件因公务事由入境的外国、国际组织官员其随行配偶、未成年子女/ Government official,
official of international organizations holding a diplomatic passport or other corresponding travel document visiting China for
official purposes and accompanying spouse and/or child(ren) under the age of 18□ C 外交信使及领事信使/ Diplomatic courier or consular courier□ D 因其他外交事由入境的人员/ Other personnel visiting China for diplomatic purposes

□

公务签证/
Official visa

□ A 持公务（官员）护照或相应国际旅行证件因公务事由入境的外国、国际组织官员及随行配偶、未成年子女/ Government
official, official of international organizations holding a service/official passport or other corresponding travel document visiting
China for official purposes and accompanying spouse and/or child(ren) under the age of 18
2/6

□ B 根据中国政府与外国政府或国际组织签订的协议，入境执行中外合作交流项目的持外交、公务（官员）护照的外国、国际组织官员及随行配偶、未成年子女/ Holder of a diplomatic, service/official passport visiting China to implement a programmeof exchange and cooperation according to relevant agreements between China and other countries or internationalorganizations and accompanying spouse and/or child(ren) under the age of 18□ C 应邀入境执行中外军事交流合作项目的人员及随行配偶、未成年子女/ Military personnel invited to implement military
programme of exchange and cooperation and accompanying spouse and/or child(ren) under the age of 18□ D 因其他公务事由入境的人员/ Other personnel visiting China for official purposes请同时填写如下信息/
Please provide the following information:
常驻机构名称/ Name of the mission:□ A 外国驻华使领馆常驻外交官、领事官、行政技术人员、国际组织驻华机构常驻人员/ Member of diplomatic missions, consular posts orinternational organizations in China□□

与驻华使领馆、国际组织驻华机构相关的人员/Member of
diplomatic missions,consular posts andinternationalorganizations andtheir accompanying
family members

其他事由/Other purposes□ B 常驻人员的随居配偶或未成年子女/ Spouse or dependent child(ren)under the age of 18 accompanying the member□ C 常驻人员的其他随任亲属/ Other accompanying relative of themember□ D 作为配偶、未成年子女及其他亲属短期探望驻华使领馆的常驻人员/
Spouse, child(ren) under the age of 18 or other relative visiting memberof diplomatic missions, consular posts or international organizations fora short visit□ E 驻华使领馆、国际组织驻华机构短期聘用（不超过 90 日）的雇员（包括私人雇员）、实习生/ Short-term (no more than 90 days)employee(including private employee), intern in diplomatic missions, consular
posts or international organizations□ F 驻华使领馆、国际组织驻华机构长期聘用（超过 90 日）的雇员（包括私人雇员）、实习生/ Long-term (more than 90 days)employee(including private employee), intern in diplomatic missions, consular
posts or international organizations（请说明）/ (Please specify)

是否新任（如选“A”请回答）/ Is it a new job position
for the above mentioned mission (if choose A )？
□ 是/Yes□ 否，前任者为/No. Name of previous occupant:常驻人姓名（如选“B”、“C”、“D”请回答）/Name of the member of diplomatic missions,consular posts or international organizations (ifchoose B, C or D):

礼遇签证由签证机关决定，颁发给需要给予礼遇的人员。/ Courtesy visas are issued at the discretion of the Chinese authorities.
□ 加急/ Express （必填／Ｒｅｑｕｉｒｅｄ＊）

2.2 服务种类/ Service：□ 正常/ Normal

2.3
申请签证信息/Visa details

2.3A 申请签证的有效期/ Validity of visa：（必填／Ｒｅｑｕｉｒｅｄ＊）

月/ month(s)（必填／Ｒｅｑｕｉｒｅｄ＊）

2.3B 申请的最长停留期/ Maximum durationoflongest stay：日/day(s)2.3C 次数/ Entries: □ 1 次/ Single□ 2 次/ Double（必填／Ｒｅｑｕｉｒｅｄ＊）□ 多次/ Multiple

三、工作情况 Work Information
3.1 当前职业/ Current occupation:□ 议员/ Member of Parliament□ 乘务人员/ Crew member□ 商人/ Businessperson□ 政府官员/ Government official□ 自雇/ Self-employed□ 公司职员/ Company employee□ 非政府组织人员/ NGO staff□ 无业/ Unemployed□ 演艺人员/ Entertainer□ 军人/ Military personnel□ 退休/ Retired□ 工人/农民/ Industrial/Agricultural worker□ 宗教人士/ Religious personnel□ 学者/Academic□ 学生/Student□ 新闻从业人员/ Media representative（必填／Ｒｅｑｕｉｒｅｄ＊）□ 其他（请说明）/Other (Please specify)：
3.2 近 5 年工作经历/ Work experience in the past 5 years
3.2A 日期/Date
从/From

到/To

3.2B 单位/公司的名称、地址、电话/Name, address and telephone of yourcurrent and previous employers

3.2C 主管姓名、电话
/Supervisor's name andtelephone（必填／Ｒｅｑｕｉｒｅｄ＊）（必填／Ｒｅｑｕｉｒｅｄ＊）（必填／Ｒｅｑｕｉｒｅｄ＊）

3.2D 职位/Position

四、教育背景 Education
4.1 最高学历/Highest diploma/degree
4.1A 学校名称/Name of institution

4.1B 学历/学位/Diploma/degree（必填／Ｒｅｑｕｉｒｅｄ＊）（必填／Ｒｅｑｕｉｒｅｄ＊）

五、家庭情况 Family Information
5.1 现家庭住址/ Current residence address（必填／Ｒｅｑｕｉｒｅｄ＊）

3/6

4.1C 专业/Major

3.2E 职责/Duty

5.2 电话号码/Phone number ： （必填／Ｒｅｑｕｉｒｅｄ＊）

5.3 手机号码/ /Mobile phone number： （必填／Ｒｅｑｕｉｒｅｄ＊）

5.4 电子邮箱/ E-mail address： （必填／Ｒｅｑｕｉｒｅｄ＊）
5.5 家庭成员/ Family member(s)5.5A 配偶/ Spouse
姓名/
Name
出生日期/
Date of birth地址/Address
5.5B 父亲/ Father
姓名/
Name

（必填／Ｒｅｑｕｉｒｅｄ＊）（必填／Ｒｅｑｕｉｒｅｄ＊）

国籍/
Nationality
出生国家/
Country of birth（必填／Ｒｅｑｕｉｒｅｄ＊）

是否在中国/Is your father in China?
□ 是/Yes□ 否/No（必填／Ｒｅｑｕｉｒｅｄ＊）（必填／Ｒｅｑｕｉｒｅｄ＊）（必填／Ｒｅｑｕｉｒｅｄ＊）职业/Occupation
出生城市/City of birth（必填／Ｒｅｑｕｉｒｅｄ＊）

国籍/
出生日期/
（必填／Ｒｅｑｕｉｒｅｄ＊）Nationality
Date of birth
如是，请填写在中国的状态/If so, the status in China（必填／Ｒｅｑｕｉｒｅｄ＊）□ 公民/ Citizen□ 永久居留/ Permanent resident□ 居留/ Resident□ 工 作 类 居 留 （ 有 效 期 90 日 至 5 年 ） /Work-type resident valid for 90 days to five years□ 非工作类居留（有效期 180 日至 5 年）/Non
work-type resident valid for 180 days to five years□ 停留/Stay□ 工作签证（有效期少于 90 日）/ Z visa valid
for less than 90 days
□ 非工作签证（有效期少于 180 日）/Visas otherthan Z valid for less than 180 days

5.5C 母亲/ Mother
姓名/
Name

（必填／Ｒｅｑｕｉｒｅｄ＊）

是否在中国/Is your father in China?
□ 是/Yes□ 否/No（必填／Ｒｅｑｕｉｒｅｄ＊）

国籍/
出生日期/
（必填／Ｒｅｑｕｉｒｅｄ＊）Nationality
Date of birth
如是，请填写在中国的状态/If so, the status in China（必填／Ｒｅｑｕｉｒｅｄ＊）□ 公民/ Citizen□ 永久居留/ Permanent resident□ 居留/ Resident□ 工 作 类 居 留 （ 有 效 期 90 日 至 5 年 ） /Work-type resident valid for 90 days to five years□ 非工作类居留（有效期 180 日至 5 年）/Non
work-type resident valid for 180 days to five years□ 停留/Stay□ 工作签证（有效期少于 90 日）/ Z visa valid
for less than 90 days
□ 非工作签证（有效期少于 180 日）/Visas otherthan Z valid for less than 180 days

5.5D 子女/ Child
姓名/
国籍/
出生日期/
（必填／Ｒｅｑｕｉｒｅｄ＊）（必填／Ｒｅｑｕｉｒｅｄ＊）NameNationality
Date of birth
姓名/
国籍/
出生日期/
Name
Nationality
Date of birth
5.5E 是否有父母以外的直系亲属在中国/ Do you have any immediate relatives, not including parents, in China?
□ 是/Yes
如有，请填写以下信息/If yes, please provide the following information:（必填／Ｒｅｑｕｉｒｅｄ＊）（必填／Ｒｅｑｕｉｒｅｄ＊）□ 否/No与您的关系/Relationship toyou

姓名/Name
在中国的状态/Status in China□ 公民/ Citizen□ 永久居留/ Permanent resident□ 居留/ Resident□ 工作类居留（有效期 90 日至 5 年）
/ Work-type resident valid for 90 days
to five years□ 非工作类居留（有效期 180 日至 5 年）/Non work-type resident valid for
180 days to five years□ 停留/Stay□ 工作签证（有效期少于 90 日）/ Z visa valid for less than 90 days
□ 非工作签证（有效期少于 180 日）/Visas other than Z valid for less than
180 days可另附纸说明/ List on a separate page if there is not enough space

六、旅行信息 Information About Your Intended Trip
6.1A 抵达日期/ Date of arrival：（必填／Ｒｅｑｕｉｒｅｄ＊）
6.1D 停留城市/ City
6.1 行程/ Itinerary

6.1B 抵达车/船/飞机班次/ Arrival train /ship /flightnumber:6.1E 地址/ Address（必填／Ｒｅｑｕｉｒｅｄ＊）

4/6（必填／Ｒｅｑｕｉｒｅｄ＊）

6.1F 到达日期/ Date of arrival

6.1G 离开日期/ Date of departure（必填／Ｒｅｑｕｉｒｅｄ＊）（必填／Ｒｅｑｕｉｒｅｄ＊）

6.1H 离境日期/ Date of departure： 6.1J 离境车/船/飞机班次/ Departure train /ship /flightnumber：（必填／Ｒｅｑｕｉｒｅｄ＊）

6.1C 抵达城市/ City of arrival:

6.1K 离境城市/City of departure：（必填／Ｒｅｑｕｉｒｅｄ＊）6.2 中国境内邀请方/联系人或组织/Inviting person ororganization inChina

6.3 紧急联系人/
Emergency contact

6.2A 姓名或名称/Name of person or organization：

6.2B（联系人）与您的关系/ Relationship to you (if invited by an individual)：

6.2C 电话号码/ Phone number：

6.2D 电子邮箱/ E-mail address：

6.2E 地址（城市、省/自治区、邮政编码）/ Address (city, province /state, postal code)：
6.3A 紧急联系人姓名/ Name of emergency contact：

6.3B 与您的关系/ Relationship to you：

6.3C 电话号码/ Phone number：

6.3D 电子邮箱/ E-mail address：（必填／Ｒｅｑｕｉｒｅｄ＊）（必填／Ｒｅｑｕｉｒｅｄ＊）（必填／Ｒｅｑｕｉｒｅｄ＊）

6.4A □ 自己/ Self
6.4B □ 他人/ Other
6.4 谁支付本次旅行
费用/Who will pay
for this travel

姓名/Name（必填／Ｒｅｑｕｉｒｅｄ＊）

名称/Name电话/Telephone

邮箱/Email

6.4C □ 单位或组织/Organization
关系/Relationship to you

地址/Address

国家/Country

6.5A 是否有偕行人（指使用同一本护照）/ Are you travelling with someone else this time（using the same passport)?
□ 是/ Yes□ 否/ No
6.5B 偕行人姓名/
Name(s) of travellingcompanion(s)6.5C 性别/ Gender
6.5 偕行人/
Travelcompanion(s)for this visit□男/ Male□女/ Female□男/ Male□女/ Female□男/ Male□女/ Female□男/ Male□女/ Female

6.5D 出生日期/
Date of birth

6.5E 请将偕行人照片粘贴在此/
Please affix theirphoto(s)偕行人 1
照片Photo of person
sharing the same
passport

偕行人 2
照片Photo of person
sharing the same
passport

偕行人 3
照片Photo of person
sharing the same
passport

偕行人 4
照片
Photo of person
sharing the same
passport

七、以往旅行信息 Past Travel Information
7.1 是否来过中国/ Have you been to China？

□ 是/ Yes □ 否/ No （必填／Ｒｅｑｕｉｒｅｄ＊）

7.2A 是否曾获得中国签证/ Have you been issued a Chinese visa？
□ 是/Yes□ 否/No（如是，请提供最近一次中国签证的详细信息）/(If yes, please give details of your last Chinese visa)

7. 2
原签证信息/
Previous
Chinese Visa

7.2B 签证种类/ Type of Visa：

7.2C 签证号码/ Number of Visa：

7.2D 签发地点/ Place of issue：

7.2E 签发日期/ Date of issue：

7.2F 申请中国签证时是否曾被采集十指指纹/ Have you ever been fingerprinted when applying for a Chinese visa？ □ 是/ Yes □ 否/ No
如是，请提供如下信息/ If yes, please provide
the following information:

采集地点/ Where were you fingerprinted?

采集时间/ When were you fingerprinted?

7.2G 是否曾获得中国居留证件/ Have you ever been issued a Chinese residence permit？ □ 是/ Yes
如是，请提供居留证件号码/ If yes, please provide your residence permit number：
7.3 有效的其
他国家签证/
Valid visas
7.4 近 12 个月年曾访问的国家/ Countries
visited in thepast 12months（必填／Ｒｅｑｕｉｒｅｄ＊）□ 否/ No

是否持有仍在有效期内的其他国家签证/ Do you currently hold any valid visas issued by other countries？
□ 是/ Yes□ 否/ No
如是，请列举/ If yes, please list below:（必填／Ｒｅｑｕｉｒｅｄ＊）过去 12 个月是否到访过其他国家/ Have you travelled to any other countries in the past 12 months？
（必填／Ｒｅｑｕｉｒｅｄ＊）□ 是/ Yes□ 否/ No
如是，请列举/ If yes, please list below. 可另附纸说明/ List on a separate page if there is not enough space:

5/6

八、其他事项 Other Information
8.1 是否曾经被拒绝签发中国签证,或被拒绝进入中国？ Have you ever been refused a visa for
China, or been refused entry into China?

□ 是/ Yes□ 否/ No（必填／Ｒｅｑｕｉｒｅｄ＊）（如是，请详细说明）/ (If yes, please specify)

8.2 是否曾被注销过中国签证?/Has your Chinese visa ever been cancelled？

□ 是/ Yes□ 否/ No（必填／Ｒｅｑｕｉｒｅｄ＊）（如是，请详细说明）/ (If yes, please specify)

8.3 是否曾非法入境中国或在华非法滞留、非法就业?/Have you ever entered China illegally,
overstayed, or worked illegally？

□ 是/ Yes□ 否/ No（必填／Ｒｅｑｕｉｒｅｄ＊）（如是，请详细说明）/ (If yes, please specify)

8.4 是否在中国或其他国家有犯罪记录?/Do you have any criminal record in China or any
other country？

（必填／Ｒｅｑｕｉｒｅｄ＊）□ 是/ Yes□ 否/ No（如是，请详细说明）/ (If yes, please specify)

8.5 是 否 有 严 重 精 神 障 碍 或 传 染 性 疾 病 ？ /Do you have any serious mental disorder or
infectious disease?

□ 是/ Yes□ 否/ No（必填／Ｒｅｑｕｉｒｅｄ＊）（如是，请详细说明）/ (If yes, please specify)

8.6 近 30 日内是否前往过流行性疾病传染的国家或地区？/Have you ever visited countries or
territories where there is an epidemic in the last 30 days?
8.7 是否具有枪械、炸药、核装置、生物或化学方面的特殊技能或接受过特殊培训？/Have you ever been trained or do you have any special skills in the field of firearms, explosives,
nuclear devices, biological or chemical products?

（必填／Ｒｅｑｕｉｒｅｄ＊）□ 是/ Yes□ 否/ No（如是，请详细说明）/ (If yes, please specify)（必填／Ｒｅｑｕｉｒｅｄ＊）□ 是/ Yes□ 否/ No（如是，请详细说明）/ (If yes, please specify)

8.8 是否（曾）在部队服役？/ Are you serving or have you ever served in the military? □ 是/ Yes（如是，请提供以下信息）/ (If yes, please provide the following information)□ 否/ No（必填／Ｒｅｑｕｉｒｅｄ＊）

8.8A 服役国家/ Country of service：

8.8B 军种/ Branch of service：

8.8C 军衔/ Rank in military：

8.8D 军事特长/ Military specialty：

8.8E 开始服役时间/ Date of service from(yyyy-mm)：

8.8F 结束服役时间/ Date of service to (yyyy-mm)：

8.9 是否曾服务于或参加过准军事性组织、民间警戒单位、游击队或叛乱组织，或曾经是其中
成员之一？/ Have you served or participated in any paramilitary organization, civil armed
units, guerrilla forces or armed organizations, or been its member?
8.10 是否任职于任何职业机构、社会机构、慈善机构？/
Have you worked for any professional, social, or charitable organizations?

（必填／Ｒｅｑｕｉｒｅｄ＊）□ 是/ Yes□ 否/ No（如是，请详细说明）/ (If yes, please specify)

8.11 是否有其他需要声明的事项？/ Is there anything else you want to declare?

（必填／Ｒｅｑｕｉｒｅｄ＊）□ 是/ Yes□ 否/ No（如是，请详细说明）/ (If yes, please specify)（必填／Ｒｅｑｕｉｒｅｄ＊）□ 是/ Yes□ 否/ No（如是，请详细说明）/ (If yes, please specify)（详细说明）/(Detailed description)

九、签名及声明 Signature & Declaration
9.1 本人填写/ For Applicant
9.1A 声明/ Declaration
我声明，我已阅读并理解此表所有内容要求，并愿就所填报信息和申请材料的真实性承担一切法律后果。
I hereby declare that I have read and understood all the questions in this application and shall bear all the legal consequences for the authenticity of theinformation and materials I provide.
我理解，能否获得签证、获得何种签证、入境次数以及有效期、停留期等将由领事官员决定，任何不实、误导或填写不完整均可能导致签证申请被拒绝或
被拒绝进入中国。
I understand that whether to issue a visa, the type of visa, number of entries, validity and duration of each stay will be determined by consular officials, andthat any false, misleading or incomplete statement may result in the refusal of a visa for or denial of entry into China.
我理解，签证申请加急服务须经领事官员批准，将加收相应费用。
I understand that express and urgent visa applications need approval of consular officials, and extra fees may apply.
我理解，根据中国法律，申请人即使持有中国签证仍有可能被拒绝入境。
I understand that, according to Chinese law, applicant may be refused entry into China even if a visa is granted.
我的签证申请将提交至位于
My application will be submitted at
申请人签名Applicant’s signature:（城市）的中国签证机关。
(City) to the Chinese visa issuing authority.
日期
Date (yyyy-mm-dd):

注：未满 18 周岁的未成年人须由父母或监护人代签。 Note: A parent or guardian should sign on behalf of a minor under the age of 18.

9.2 代填人填写/ For person filling in the application on the applicant’s behalf
9.2A 姓名/ Name：

9.2B 与申请人的关系/ Relationship with the applicant：9.2C 地址/ Address：

9.2D 电话/ Telephone：

9.2E 声明/ Declaration
我声明本人是根据申请人要求而协助填表，证明申请人理解并确认表中所填内容准确无误。
I declare that I have assisted in the completion of this form at the request of the applicant and that the applicant understands and agrees that the information
provided is true and correct.
代填人签名/ Signature:

日期/ Date(yyyy-mm-dd):
6/6