The following 4 pages show the China visa application. Please fill out the application IN CAPITAL LETTERS, and cannot be handwritten. Do not leave any

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1 At the end of this guide, you will have a partially completed application for your Chinese Visa Application. Please ensure you complete it with your personal information. Please fill out the application IN CAPITAL LETTERS, and cannot be handwritten. Do not leave any answer blank, put N/A if the question does not apply to you. Please note the format that China uses for dates: Year/Month/Day. Jurisdictions: Below is a list of Travisa locations which will process your Chinese visa application based on your state of residence. Chicago: Colorado, Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, and Wisconsin. New York: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, and Vermont. Houston: Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, Oklahoma and Texas. San Francisco: Alaska, Northern California, Nevada, Oregon, and Washington. Los Angeles: Arizona, Southern California, Hawaii, New Mexico, and Pacific Islands. Washington DC: Delaware, District of Columbia, Idaho, Kentucky, Maryland, Montana, Nebraska, North Carolina, North Dakota, Puerto Rico, South Carolina, South Dakota, Tennessee, Utah, Virginia, West Virginia, and Wyoming. 1

2 The following 4 pages show the China visa application. Please fill out the application IN CAPITAL LETTERS, and cannot be handwritten. Do not leave any answer blank, put N/A if the question does not apply to you. Please note the format that China uses for dates: Year/Month/Day. 1.1 Name must match your passport. If you do not have a middle name in your passport, write, N/A 1.2 If you were born in China, Taiwan or Hong Kong, you must complete Please follow China s format for dates, yyyy/mm/dd. 1.6 Should match where your current passport is from. 1.7 If you were born in Taiwan, simply list China. If you were born in the US, list N/A here. 1.8 Please be sure to list City, State and Country. 1.9 If you do not have a driver s license, you can write N/A or None. If you live in San Francisco s jurisdiction and do not have a driver s license, please list your passport number here Type 'P' passports are Ordinary passports This should match what is listed under Authority on your passport. 2

Please fill out the application IN CAPITAL LETTERS, and cannot be handwritten. Do not leave any answer blank, put N/A if the question does not apply to you.

3 Please fill out the application IN CAPITAL LETTERS, and cannot be handwritten. Do not leave any answer blank, put N/A if the question does not apply to you. Please note the format that China uses for dates: Year/Month/Day. 1.18/1.19 Provide your current address here. You cannot list a PO Box You must list at least one immediate family member here (spouse, parent, sibling, etc.). If you are married, you must list your spouse List the person from 1.23 here List USA here. 2.1 All Semester at Sea applicants should pick Tourism. 2.2 US applicants should choose Other and type: Multiple Entries valid for 10 years from the date of issue. Non-US passport holders should choose 'Two entries valid for 3-6 months from date of issue'. 3

4 Please fill out the application IN CAPITAL LETTERS, and cannot be handwritten. Do not leave any answer blank, put N/A if the question does not apply to you. Please note the format that China uses for dates: Year/Month/Day. 2.9 Please list the date of issue, and place of issue of your most recent China visa here, or write No List all the countries you ve visited in the past 12 months or write, N/A or NONE here If you answer Yes to any of these questions, you must include a signed letter of explanation. 3.3 You must include a court document which shows what the crime and punishment were, if applicable. 3.6 See notes above. Write, See attached documents here if you answered yes to any of these questions; otherwise, write N/A here. 4

5 Please fill out the application IN CAPITAL LETTERS, and cannot be handwritten. Do not leave any answer blank, put N/A if the question does not apply to you. Please note the format that China uses for dates: Year/Month/Day. 3.8 Write N/A here unless you have a dependent listed in your passport (this is fairly unusual). 4.3 Applicant must sign here using a black or blue pen. Make sure that it is dated as well Must be filled and signed by the person who completed the application on behalf of the applicant. 5

6 Form V.2013 中华人民共和国签证申请表 Visa Application Form of the People s Republic of China (For the Mainland of China only) 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选择如有关项目不适用请写无 The applicant should fill in this form truthfully completely and clearly. Please type the answer in capital English 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 Part 1: Personal Information 姓 Last name 1.1 英文姓名 Full English name as in passport 粘贴一张近期正面免冠浅色背景的彩色护照照片中间名 Middle name 照片/Photo 名 First name 1.2 中文姓名 Name in Chinese 1.4 性别 Sex Affix one recent color passport photo (full face, front view, bareheaded and against a plain light colored background). 1.3 别名或曾用名 Other name(s) 男 M 1.5 出生日期 DOB(yyyy-mm-dd) 女 F 1.6 现有国籍 Current nationality(ies) 1.7 曾有国籍 Former nationality(ies) 1.8 出生地点(市省/州国) Place of birth(city, province/state,country) 1.9 身份证/公民证号码 Local ID/ Citizenship number 1.10 护照 / 旅行证件种类 Passport/Travel document type 外交 Diplomatic 公务官员 Service or Official 普通 Ordinary 其他证件(请说明) Other (Please specify): 1.11 护照号码 Passport number 1.12 签发日期 Date of issue(yyyy-mm-dd) 1.13 签发地点 Place of issue 1.14 失效日期 Date of expiry(yyyy-mm-dd) 商人 Businessperson 前/现任议员 Former/incumbent member of parliament 公司职员 Company employee 1.15 当前职业可选多项 Current occupation(s) 职位 Position 演艺人员 Entertainer 前/现任政府官员 Former/incumbent government 工人/农民 Industrial/Agricultural worker official 职位 Position 学生 Student 军人 Military personnel 乘务人员 Crew member 职位 Position 自雇 Self-employed 无业 Unemployed 非政府组织人员 NGO staff 退休 Retired 宗教人士 Religious personnel 新闻从业人员 Staff of media 其他(请说明) Other (Please specify): 1.16 受教育程度 Education 1.17 工作单位/学校研究生 Postgraduate 其他(请说明) Other (Please specify): 大学 College 名称 Name 联系电话 Phone number 地址 Address 邮政编码 Zip Code Employer/School 第 1页共 4 页 / Page 1 of 4

7 1.18 家庭住址 Home address 1.19 邮政编码 Zip Code 1.20 电话/手机 Home/mobile phone number 1.21 电子邮箱 address 1.22 婚姻状况 Marital status 已婚 Married 单身 Single 姓名 Name 其他 Other(Please specify): 国籍 Nationality 职业 Occupation 关系 Relationship 1.23 主要家庭成员 (配偶子女父母等,可另纸) Major family members spouse, children,parents,et c.,may type on separate paper 1.24 紧急联络人信息 Emergency Contact SARAH MARTINEZ 姓名 Name 与申请人的关系 Relationship with the applicant 手机 Mobile phone number TRAVEL COORDINATOR 1.25 申请人申请签证时所在的国家或地区 Country or territory where the applicant is located when applying for this visa USA 二旅行信息 Part 2: Travel Information 官方访问 Official Visit 交流考察访问 Non-business visit 常驻外交领事国际组织人员 As resident diplomat consul or staff of international organization 永久居留 As permanent resident 商业贸易 Business & Trade 工作 Work 人才引进 As introduced talent 寄养 As child in foster care 旅游 Tourism 执行乘务 As crew member 过境 Transit 2.1 申请入境事由 Major purpose of your visit 短期探望中国公民或者具有中国永久居留资格的外国人 Short-term visit to Chinese citizen or foreigner with Chinese permanent residence status 短期探望因工作学习等事由在中国停留居留的外国人 Short-term visit to foreigner residing in China due to work, study or other reasons 短期学习 Short-term study for less than 180 days 短期采访报道 As journalist for temporary news coverage 与中国公民或者具有中国永久居留资格的外国人家庭团聚居留超过 180 日 Family reunion for over 180 days with Chinese citizen or foreigner with Chinese permanent residence status 长期探望因工作学习等事由在中国居留的外国人 As accompanying family member of foreigner residing in China due to work, study or other reasons 长期学习 Long-term study for over 180 days 外国常驻中国新闻机构记者 As resident journalist 其他(请说明)Other (Please specify) 一次(自签发之日起 3 个月有效) One entry valid for 3 months from the date of issue 2.2 计划入境次数 Intended number of entries 二次(自签发之日起 3-6 个月有效) Two entries valid for 3 to 6 months from the date of issue 半年多次自签发之日起 6 个月有效) Multiple entries valid for 6 months from the date of issue 一年多次自签发之日起 1 年有效) Multiple entries valid for 1 year from the date of issue 其他请说明 Other (Please specify): 2.3 是否申请加急服务 Are you applying for express service? 注加急服务须经领事官员批准将加收费用 Note: Express service needs approval consular officials, and extra fees may apply. of 2.4 本次行程预计首次抵达中国的日期 Expected date of your first entry into China on this trip (yyyy-mm-dd) 第 2页共 4 页 / Page 2 of 4 是 Yes 否 No

8 2.5 Longest intended stay in China among all entries Days Date Detailed address 2.6, Itinerary in China (in time sequence may type on separate paper) 2.7 Who will pay for your travel and expenses during your stay in China? Name 2.8 Address Information of inviter in China Phone number Relationship with the applicant 2.9 Have you ever been granted a Chinese visa? If applicable, please specify the date and place of the last time you were granted the visa Other countries or territories you visited in the last 12 months Part 3: Other Information 3.1 Have you ever overstayed your visa or Yes No residence permit in China? 3.2, Have you ever been refused a visa for China, or been refused entry into China? 3.3 Do you have any criminal record in China or any other country? 3.4 Are you experiencing any of the following conditions? Serious mental disorder Infectious pulmonary tuberculosis Other infectious disease of public health hazards Yes Yes Yes Did you visit countries or territories affected Yes by infectious diseases in the last 30 days? If you select Yes to any questions from 3.1 to 3.5, please give details below. No No No No 3 4 / Page 3 of 4

9 3.7 If you have more information about your visa application other than the above to declare,please give details below or type on a separate paper. 3.8 If someone else travels and shares the same passport with the applicant, please affix their photos and give their information below. Information 1 Person 1 Affix Photo here 2 Person 2 Affix Photo here 3 Person 3 Affix Photo here Full name Sex DOB(yyyy-mm-dd) Part 4: Declaration & Signature 4.1 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 the information and materials I provided. 4.2 I understand that whether to issue a visa, type of visa, number of entries, validity and duration of each stay will be determined by consular official, and that any false, misleading or incomplete statement may result in the refusal of a visa for or denial of entry into China. 4.3 I understand that, according to Chinese law, applicant may be refused entry into China even if a visa is granted. Applicant s signature: Date (yyyy-mm-dd): 18 Note: The parent or guardian shall sign on behalf of a minor under 18 years of a Part 5 If the application form is completed by another person on the applicant's behalf, please fill out the information of the one who completes the form 5.1 Name 5.2 Relationship with the applicant 5.3 Address 5.4 Phone number 5.5 Declaration 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. /Signature /Date (yyyy-mm-dd): 4 4 / Page 4 of 4

Form V.2013 中华人民共和国签证申请表 Visa Application Form of the People s Republic of China (For the Mainland of China only) 申请人必须如实完整清楚地填写本表格请逐项在空

Form V.2013 中华人民共和国签证申请表 Visa Application Form of the People s Republic of China (For the Mainland of China only) 申请人必须如实完整清楚地填写本表格请逐项在空 Important Instructions for China Visa Application The China Visa Application is below on Pages 2-5. Please review these important notes. The application form must be typed in ALL CAPITAL LETTERS. Handwritten