韩国新签证申请表格样本

■출입국관리법시행규칙 [별지제17호서식] <개정2018. 6. 12.> (第1页/ Page1)大韩民国签证申请表APPLICATION FOR VISA<申请表填写指引>‣申请人必须如实、完整、准确地填写本表格。

‣请逐项在空白处用韩文或中·英文填写。

‣请在相应的[ ]内打√选择。

‣如选择“其他”，请详细说明。

<How to fill out this form>‣You must fill out this form completely and correctly.‣You must write in block letters either in English or Korean.‣For multiple-choice questions, you must check [√] all that apply.‣If you select‘Other’, please provide us with more information in the given space.1.8是否曾用别名入境韩国或从韩国出境？Have you ever used any other names to enter or depart Korea?否No [ ] 是Yes [ ] →如是，请详细说明If‘Yes’please provide details(姓Family Name , 名Given Name )1.9是否拥有双重国籍？Are you a citizen of more than one country ? 否No [ ] 是Yes [ ]→如是，请详细说明If‘Yes’please write the countries ( )< 수입인지부착란 >二、护照信息/ PASSPORT INFORMATIONPassport Type外交Diplomatic [ ] 公务Official [ ]普通Regular [ ] 其他Other [ ] →如其他，请详细说明If‘Other’please provide details ( )2.2 护照号码Passport No. 2.3 签发国家Country of Passport 2.4 签发地点Place of Issue2.5 签发日期Date of Issue 2.6 有效期至Date Of Expiry2.7 是否持有其他有效护照？Does the invitee have any other valid passport ? 否No [ ] 是Yes [ ]→ 如是，请详细说明If ‘Yes’please provide detailsa)护照种类Passport Type外交Diplomatic [ ] 公务Official [ ]普通Regular [ ] 其他Other [ ]b)护照号码Passport No. c) 签发国家Country of Passport d) 有效期至Date o f Expiry三、联系信息/ CONTACT INFORMATION3.1本国住址Address in Your Home Country3.2现居住地址Current Residential Address *若与本国住址不同，请填写/ Write if it is different from the above address3.3手机Cell Phone No. 3.4 电话Telephone No. 3.5 电子邮箱E-mail3.6 紧急情况联系人信息Emergency Contact Informationa) 姓名Full Name in English b) 居住国家Country of R esidencec) 电话Telephone No. d) 与申请人关系Relationship to you四、婚姻状况及家庭成员信息/ MARITAL STATUS AND FAMILY DETAILS已婚Married [ ] 离婚Divorced [ ] 单身Single [ ]4.2配偶信息Personal Information of Your Spouse *仅限已婚人士If‘Married’please provide details of your spousea) 姓Family Name (in English) b) 名Given Names (in English)c) 出生日期Date of Birth (yyyy/mm/dd) d) 国籍Nationalitye) 居住地址Residential Address f) 联系电话Contact No.4.3是否有子女？Do you have children?否No [ ] 是Yes [ ] 子女人数Number of children [ ]五、学历/ EDUCATION5.1 最高学历What is the highest degree or level of education the invitee has completed ?硕士/博士Master’s/Doctoral Degree [ ] 学士Bachelor’s Degree [ ] 高中High School Diploma [ ] 其他Other [ ]→如其他，请详细说明If‘Other’please provide details ( )5.2 学校名称Name of School/Current personal circumstances事业家 Entrepreneur [ ] 自雇 Self-Employed [ ]公司职员 Employed [ ]公务员 Civil Servant [ ]学生 Student [ ] 退休 Retired [ ]无业 Unemployed [ ]其他Other [ ]→ 如其他，请详细说明 If‘Other’please provide details ( )6.2 职业详细信息 Employment DetailsPurpose of Visit to Korea旅游 过境 Tourism/Transit [ ] 参加会议等活动Meeting, Conference [ ]医疗旅游 Medical Tourism [ ]短期商务 Business Trip [ ] 学习/培训 Study/Training [ ]就业活动 Work [ ]贸易/投资/派驻Trade/Investment/Intra-CorporateTransferee [ ] 探亲访友Visiting Family/Relatives/Friends[ ]结婚移民 Marriage Migrant [ ]外交/公务 Diplomatic/Official [ ]其他 Other [ ]→ 如其他，请详细说明 If ‘Other ’ please provide details ( )7.6 近5年内是否访问过韩国？ Has the invitee travelled to Korea in the last 5 years?否 No [ ] 是 Yes [ ] → 如是，请详细说明 If ‘Yes ’ please provide details of any trips to Korea ( ) 次 times, 近期入境目的 Purpose of Recent Visit ( )7.7 近5年内是否访问过除韩国外其他国家？ Has the invitee travelled outside his/her country of residence, excluding to Korea,in the last 5 years?7.8. 是否有偕行家属？ Is the invitee travelling to Korea with any family member ?无 No [ ] 有 Yes [ ] → 如有，请详细说明 If ‘Yes ’ please provide details of the family members the invitee is travelling with* 注 : 家属范围 – 申请人的配偶、子女、父母、兄弟姐妹Note : Definition of a Family Member - your spouse, father, mother, children, brothers and sistersPage4)九、费用信息 / FUNDING DETAILS十一、声明 / DECLARATION附件8.1 是否在韩国有邀请人或邀请单位？ Do you have anyone sponsoring you for the visa ?否 No [ ] 是 Yes [ ] → 如是，请详细说明 If‘Yes’please provide detailsa) 姓名或名称 Name of your visa sponsor (Korean, foreign resident in Korea, company, or institute)b) 出生日期或事业者登记证号码 Date of Birth/Business Registration No. c) 与申请人关系 Relationship to you d) 地址 Addresse) 联系电话 Phone No.9.1 在韩期间费用（以美元为准） Estimated travel costs(in US dollars)9.2 谁将承担在韩国期间的费用？ Who will pay for your travel-related expenses ? (any person including yourself and/or institute)a) 姓名/单位（或团体）名称 Name of Person/Company(Institute) b) 与申请人关系 Relationship to you c) 费用类别 Type of Supportd) 联系电话 Contact No.10.1 是否有人协助填写本表格？ Did you receive assistance in completing this form?否 No [ ] 是 Yes [ ] → 如是，请详细说明 If‘Yes’please provide details of the person who assisted you姓名 Full Name出生日期 Date of Birth(yyyy/mm/dd)电话 Telephone No. 与申请人关系Relationship to you本人声明，本人已确认本表格内所填内容真实、准确无误，并保证遵守大韩民国《出入国管理法》有关规定。

签证申请表 APPLICATION FOR VISA※ 签证发给认定号码[反签号] (CONFIRMATION OF VISA ISSUANCE NO. ) :1.姓(拼音) Surname 3.汉字姓名4.性别 Gender[ ]M [ ]F2.名(拼音) Given Names5.出生日期 Date of Birth6.国籍 Nationality 中国7.出生地点 Country of Birth8.现住所 Home Address 9.固定电话号码 Phone NO. 10.手机号码 Cell Phone照 片 PHOTO3.5㎝×4.5㎝11.电子邮箱 E-mail12.身份证号 National Identity Number13.护照号码 Passport NO.14.护照类型 Classification外交, 公务, 公务普通, 因私, 其他 DP, OF OF, OR, OTHERS护照Passport15.签发地点 Place of Issue16.签发日期 Date of Issue17.有效期至 Date Of Expiry18.职业 Occupation19.单位电话 Business Phone NO.职业Occupation20.单位名称 Name of Present Employer 单位地址 Address of Present Employer21.[ ]未婚 Single [ ]已婚 Married [ ]丧偶 Widowed [ ]离婚 Divorced22.配偶者姓名 Spouse's Name23.配偶者出生日期 Spouse's Date of Birth 婚姻状况 Marital status24.配偶者国籍 Spouse's Nationality25.配偶者联系电话 Spouse's TEL26.赴韩目的 Purpose of Entry 旅游 27.在韩停留时间 Potential Length of Stay28.预定赴韩日期 Potential Date of Entry 29.过去有无访韩经历 Previous Visit (If Any) 有 无 30.韩国内停留地 Address in Korea31.韩国内联系电话 Phone NO. in Korea32.此次赴韩费用支付者 Who Will Pay For The Expense For Your Stay? 自费 33.最近5年内旅行过的国家 Countries You Have Traveled During The Past 5 Years 关系 Relationship国籍 Nationality姓名 Name出生日期 Date of Birth性别 Gender34. 同伴家族AccompanyingFamily关系 Relationship国籍 Nationality姓名 Name出生日期 Date of Birth性别 Gender35. 韩国内担保人Guarantor orReference in KoreaI declare that the statements made in this application are true and correct to the best of my knowledge and belief, that I will observe the provisions of the Immigration Law of the Republic of Korea and that I will not engage in any activities irrelevant to the purpose of entry stated herein. Besides, I am fully aware that any false or misleading statement may result in the refusal of a visa, and that possession of a visa does not entitle the bearer to enter the Republic of Korea upon arrival at the port of entry if he/she is found inadmissible.申请日 D A T E OF A P PL I C A T I ON 申请人署名 S I G NA T U RE O F A P PL I C A N T공 용 란 FOR OFFICIA L USE ONLY사증종류S D M접수일자 체류자격 접수번호 체류기간 허가일자 유효기간 담 당결 재 가 · 부收入印纸（签证邮票）粘贴处수입인지 부착란B/L: 출입국사항: 복수대상사유:사 건 부: 불허경력: 기 타:불허시 사유 : 고 지 사 항 :。

韩国签证申请表（团体旅游用）申请人姓名（中文）性别：□男□女出生年月日：出生地：身份证号码：婚姻情况：□已婚□未婚□离异最高学历：职业状况：□在职□退休□学生□无业或个体单位（学校）名称：单位电话：单位（学校）地址：家庭电话：本人手机：紧急联络人：（中国国内亲属）姓名：与申请人的关系：紧急联系方式：护照号码：护照签发地：护照有效期：无业或个体填写：财产状况：房产□存款□车辆□其他财产□一同报名参团者（亲属、朋友、同事等）：出境纪录：□无□有如果有请注明哪个国家：是否有拒签史：此次出行需缴纳违约金：□3万□5万预定出发日：年月日出团目的：旅游□备注：1、如您已是60岁周岁以上老人，我们必须与您的家人确认您的身体状况，以便保证您的出行。

2、目前您所看到的行程是参考行程，如不成团我社提前5天通知；团队出行后在不减少景点的情况下我社有权根据最终内陆航班时间将行程调整。

3、如因您自身原因，隐瞒自己的身体状况，如在境外产生的所有医疗费用由您本人承担！4、我担保我所填写的内容一切属实，如因我所填写的申请资料不真实，不完整而导致拒签，我愿意承担相应的损失费！5、我承认签证由领馆决定，我愿意接受领馆作出的任何决定！6、如签证签出，本人要求退团，本人将按规定承担相应的损失费！7、我保证在韩国无亲属及朋友，我保证随团旅游，不会擅自离团！我愿意接受出团前交纳违约金，回国后我将本人前往旅行社或指定银行退取！如我本人未能随团回国，则有旅行社没收违约金！8、无业人员需缴纳5万元违约金！以上我提供均属实！此表格为合同的附件起同等的法律效应！申请年月日：年月日申请人签名如因个人原因，领馆有权要求个人提供其他相应的签证材料！。

韩国签证申请表（单次填写）■ 出入境管理法实行规则 [第17号样式]签证发给申请表APPLICATION FOR VISA<申请表填写方法> ? 申请人须以事实为根据，并将在以下空格处完整记载。

? 申请人必须用中文或英文填写以下申请表。

? 在相关选项的“[ ]”内打钩。

? 如您选择“其他”，请写具体内容。

? You must fill out this form completely and correctly. ? You must write in block letters either in English or Korean. ? For multiple-choice questions, you must check [√] all that apply. ? If you select‘Other’, please provide us with more information in the given space.1. 个人信息 / PERSONAL DETAILS1.1 护照上的英文姓名/Full name in English (as shown in your passport)PHOTO 护照规格照片 (35㎜×45㎜) 6个月内拍摄的正面免冠彩色相片，相片背景颜色须为纯白色 A color photo taken within la st 6 months(full face without hat, front view against whit e or off-white background)姓 Family NameCAO名 Given NamesLU1.2 中文姓名漢字姓名曹璐1.3 性别 Sex男/Male[ 中国 ] 女/Female[ √ ]1.4 出生日期 Date of Birth (yyyy/mm/dd)1990/10/181.5 国籍 Nationality 1.7 身份证号码 National Identity No.350802************1.6 出生国 Country of Birth中国1.8 过去访韩时是否使用过其他姓名Have you ever used any other names to enter or depart Korea? 否No [√ ] 是Yes [ ] → 选择‘是’选项时填写详细内容。

韩国签证申请表（团体旅游用）申请人姓名（中文）性别：□男□女出生年月日：出生地：身份证号码：婚姻情况：□已婚□未婚□离异最高学历：职业状况：□在职□退休□学生□无业或个体单位（学校）名称：单位电话：单位（学校）地址：家庭电话：本人手机：紧急联络人：（中国国内亲属）姓名：与申请人的关系：紧急联系方式：护照号码：护照签发地：护照有效期：无业或个体填写：财产状况：房产□存款□车辆□其他财产□一同报名参团者（亲属、朋友、同事等）：出境纪录：□无□有如果有请注明哪个国家：是否有拒签史：预定出发日：年月日出团目的：旅游□此次出行需缴纳逾期不归违约金：□3万□5万（此项由旅行社审核后由旅行社填写）备注：1、如因申请人隐瞒自己的身体的健康状况，则在境外产生的所有医疗费用由申请人承担！如申请人已是60岁周岁以上的老人，请申请人确认自己身体状况是否适合此次旅行。

2、目前申请人所看到的行程是参考行程，如不成团，旅行社将提前5天通知；团队出行后在不减少景点的情况下旅行社有权根据最终内陆航班时间调整行程。

3、申请人声明保证所填写的内容一切属实，如因申请人所填写的申请资料不真实、不完整而导致拒签，申请人愿意承担相应的损失费（包括但不限于机票、签证费）。

4、根据外交惯例，领馆有权对签证作出任何其认为恰当的决定而无须作出任何解释。

申请人应当知晓签证的结果必须接受且与旅行社无关。

5、领馆准许申请人入境签证后，而申请人要求退团，申请人同意按规定承担相应的损失费用。

6、申请人保证在韩国无亲属及朋友，保证随团旅游，不会擅自离团！同意向旅行社在出团前缴纳逾期不归违约金。

如有违反，则同意承担违约责任。

团队回国后申请人即可前往旅行社或指定银行退取逾期不归违约金。

如申请人未能按时随团回国，则由旅行社没收违约金！7、无业人员需向旅行社缴纳5万元逾期不归违约金！8、如因个人原因，领馆及旅行社有权要求申请人提供其他相应的签证材料！9、申请人声明以上内容均为事实，并清楚地认识到本人的入境资格、居留期限将在本人到达韩国时均由韩国移民官员决定。

■ 출입국관리법 시행규칙 [별지 제17호서식](第一页 / Page1)签证发给申请表APPLICATION FOR VISA<申请表填写方法>‣ 申请人须以事实为根据，并将在以下空格处完整记载。

‣ 申请人必须用韩文或英文填写以下申请表。

‣ 在相关选项的“[ ]”内打钩。

‣ 如您选择“其他”，请写具体内容。

<How to fill out this form>‣ You must fill out this form completely and correctly. ‣ You must write in block letters either in English or Korean. ‣ For multiple-choice questions, you must check [√] all that apply.‣ If you select‘Other’, please provide us with more information in the given space.Have you ever used any other names to enter or depart Korea?否 No [ ] 是 Yes [ ] → 如您选择"是"，请写具体内容 If‘Yes’please provide details (姓 Family Name , 名 Given Name )→ 如您选择"是"，请写具体内容 If‘Yes’please write the countries ( )Those who have confirmation of visa issuance must move to section 12 (Declaration) to complete this from (Those with visa issuance confirmation must not fill out section 3~11).210mm×297mm[백상지 80g/㎡(재활용품)]3.1 护照类型 Passport Type外交护照 Diplomatic[ ]公务护照 Official [ ]普通护照 Regular[ ]其他 Other [ ]→ 如您选择‘其他’，请写具体内容 If‘Other’please provide details( )3.2 护照号码 Passport No. 3.3 护照签发国Country of Passport 3.4 护照签发地Place of Issue3.5 签发日期Date of Issue 3.6 护照有效期至 Date Of Expiry3.7 您是否有其他的护照? Do you have any other valid passport ? 否 No [ ] 是 Yes [ ]→ 如您选择‘是’，请写具体内容 If‘Yes’please provide detailsa) 护照类型Passport Type外交护照 Diplomatic[ ]公务护照 Official [ ]普通护照 Regular[ ]其他 Other [ ]b) 护照号码 Passport No. c) 护照签发国 Country of Passport d) 护照有效期至Date Of Expiry4.1 本国地址Address in Your Home Country4.1 现居住地Current Residential Address *仅限于现居住地与本国地址不同者/ Write if it is different from the above address 4.3 手机号码Cell Phone No. 4.4 电话号码Telephone No. 4.5 电子邮件 E-mail4.6 紧急联系人信息Emergency Contact Information5.1 目前婚姻状况 Current Marital Status已婚 Married [ ]离婚 Divorced [ ]未婚 Never married [ ]5.2 配偶个人信息*仅限于已婚者 If‘Married’please provide details of your spouse6.1 最终学历What is the highest degree or level of education you have completed ?硕士/博士Master’s/Doctoral Degree [ ] 学士Bachelor’s Degree [ ]高中 High School Diploma [ ]其他 Other [ ]→ 如您选择“其他”，请写具体内容 If‘Other’please provide details ( )6.2 学校名称Name of School 6.3 学校地址Location of School(city/province/country)210mm×297mm[백상지 80g/㎡(재활용품)]7.1 职业What are your current personal circumstances ?企业家 Entrepreneur [ ]个体经营 Self-Employed [ ]工作者 Employed [ ]公务员 Civil Servant [ ] 学生 Student [ ]退休者 Retired [ ]无职 Unemployed [ ] 其他 Other [ ]→ 如您选择“其他”，请写具体内容 If‘Other’please provide details ( )7.2. 职业详细信息Employment Detailsa) 单位/机构/学校（名称） Name of Company/Institute/School b) 职位/课程 Your Position/Course c) 单位/机构/学校（地址） Address of Company/Institute/School d) 电话号码 Telephone No.8.1 邀请人/邀请单位Do you have anyone sponsoring you for the visa ?无 No [ ] 有 Yes [ ] → 如您选择“有”，请写具体内容 If‘Yes’please provide details9.1 访韩目的Purpose of Visit to Korea观光/通过 Tourism/Transit [ ] 参加会议/Meeting, Conference [ ] 医疗观光 Medical Tourism [ ]短期商务 Business Trip [ ]留学/研修 Study/Training [ ]就业 Work [ ]贸易/投资/驻在 Trade/Investment/Intra -Corporate Transferee [ ]探亲 VisitingFamily/Relatives/Friends [ ] 结婚移民 Marriage Migrant [ ]外交/公务 Diplomatic/Official [ ]其他 Other [ ]→ 如您选择“其他”，请写具体内容 If‘Other’please provide details ( )210mm×297mm[백상지 80g/㎡(재활용품)]are travelling with10.1 访问经费(以美元为准) Estimated travel costs(in US dollars)10.2 访韩费用支付者 Who will pay for your travel-related expenses ? (any person including yourself and/or institute)11.1 您在填写申请表时是否接受过别人的帮助？Did you receive assistance in completing this form?否[ ] No 是 Yes [ ] → 如您选择“是”，请写具体内容 If‘Yes’please provide details of the person who assisted you根据本人所知所信，我声明以上所有陈述均真实、准确、完整。

签证申请表APPLICATION FOR VISA ※签证发给认定号码[返签证号](CONFIRMATION OF VISA ISSUANCE NO):
提供资料如下：
1.护照原件与复印件
2.身份证、户口本复印件（非本市户口提供暂住证）
3.2寸彩色相片两张
4.在职证明），公司抬头信笺公司营业执照复
印件，学生提供学生证复印件。

老人提供退休证复印件。

5.异地护照需要暂住证或者是居住证复印件。

6.无公司在职证明需提供存款RMB20000万以上的银行存折复印件
7.小童需提供出生证及父母的存款RMB20000万以上的银行存折复印件
本人郑重声明：
以上资料全部属实，如果资料欠缺或提供虚假材料而影响签证，责任全部由本人承担。

如申请人的原因被领事馆拒签，申请人必须付签证费及手续费人民币500元。

■ 출입국관리법 시행규칙 [별지 제17호서식](第一页/ Page1)签证发给申请表APPLICATION FOR VISA<申请表填写方法>‣ 申请人须以事实为根据，并将在以下空格处完整记载。

‣ 申请人必须用韩文，英文或中文填写以下申请表。

‣ 在相关选项的“[ ]”内打钩。

‣ 如您选择“其他”，请写具体内容。

<How to fill out this form>‣ You must fill out this form completely and correctly. ‣ You must write in block letters either in English or Korean. ‣ For multiple-choice questions, you must check [√] all that apply.‣ If you select ‘Other ’, please provide us with more information in the given space.1.8 您以前出境或入境韩国时是否使用过其他姓名?（根据个人真实信息填写）Have you ever used any other names to enter or depart Korea?否 No [ ] 是 Yes [ ] → 如您选择"是"，请写具体内容 If ‘Yes ’please provide details1.9 您是否拥有双重国籍? Are you a citizen of more than one country ? 否 No [ ] 是 Yes [ ]（根据个人真实信息填写）→ 如您选择"是"，请写具体内容 If ‘Yes ’please write the countries ( )‣ 签证发给认定书持有者直接移到第12部分(誓约)，填写以下空格后提交申请表(不用写第3~11部分)Those who have confirmation of visa issuance must move to section 12 (Declaration) to complete this from (Those with visa issuance confirmation must not fill out section 3~11).210mm ×297mm[백상지 80g/㎡(재활용품)]3. 护照信息/ PASSPORT INFORMATION3.1 护照类型 Passport Type（1-7项根据护照信息填写）外交护照 Diplomatic[ ]公务护照 Official [ ]普通护照 Regular[ ]其他Other [ ]→ 如您选择‘是’，请写具体内容 If‘Yes’please provide detailsa) 护照类型Passport Type外交护照 Diplomatic[ ]公务护照 Official [ ]普通护照 Regular[ ]其他Other [ ]4. 联系信息/ CONTACT INFORMATION4.1 本国地址 Address in Your Home Country （以下1-6项根据个人真实信息填写）北京市西城区黄寺大街甲23号（详细到门牌号）4.1 现居住地Current Residential Address *仅限于现居住地与本国地址不同者/ Write if it is different from the above address5. 婚姻状况/ MARITAL STATUS DETAILS5.1 目前婚姻状况 Current Marital Status（以下信息根据实际情况填写）5.2 配偶个人信息*仅限于已婚者I f‘Mar ried’please p rovide details of your spous e6. 学历/ EDUCATION6.1 最终学历 What is the highest degree or level of education you have completed ?（以下信息根据真实情况填写）硕士/博士 M a s t e r’s/D o c t o r a l D e g r e e[ ] 学士Bachelor’s Degree[ ]高中 High School Diploma[ ] 其他Other [ ]→ 如您选择“其他”，请写具体内容If‘Other’please provide details ( )210mm×297mm[백상지80g/㎡(재활용품)]7. 职业/ EMPLOYMENT7.1 职业What are your current personal circumstances ?（以下情况请根据真实情况填写）企业家 Entrepreneur [ ] 个体经营 Self-Employed [ ]工作者 Employed [ ] 公务员Civil Servant [ ] 学生Student [ ] 退休者Retired [ ]无职Unemployed [ ] 其他Other [ ]→ 如您选择“其他”，请写具体内容If‘Other’please provide details )7.2. 职业详细信息8. 邀请人信息/ DETAILS OF SPONSOR8.1 邀请人/邀请单位 Do you have anyone sponsoring you for the visa ? （a-e项不填）无 No [ ] 有 Yes [ ] → 如您选择“有”，请写具体内容 If‘Yes’please provide detailsa) 邀请人/邀请单位(名称) Name of your visa sponsor (Korean, foreign resident in Korea, company, or institute)9. 访问信息/ DETAILS OF VISIT9.1 访韩目的Purpose of Visit to Korea（一定选观光）观光/通过Tourism/Transit [ ]参加会议/Meeting, Conference [ ] 医疗观光Medical Tourism [ ] 短期商务 Business Trip [ ] 留学/研修 Study/Training [ ] 就业 Work [ ]贸易/投资/驻在 Trade/Investment/Intra-CorporateTransferee [ ]探亲 VisitingFamily/Relatives/Friends [ ]结婚移民 Marriage Migrant [ ]外交/公务 Diplomatic/Official [ ] 其他 Other [ ]→ 如您选择“其他”，请写具体内容If‘Other’please provide details ( )9.6 最近5年内是否访问过韩国? Have you travelled to Korea in the last 5 years ?（根据个人实际情况填写）否 No [ ] 是 Yes [ ] → 如您选择“是”，请写具体内容 If‘Yes’please provide detai l s of any trips to Korea( ) 次 times, 最近访韩目的 Purpose of Recent Visit ( )9.7 最近5年内是否访问过其他国家（韩国除外）Have you travelled outside your country of residence, excluding to Korea, in the last 5 years ?否 No [ ] 是 Yes [ ] → 如您选择“是”，请写具体内容If‘Yes’please provide details of these trips（根据个人实际情况填写）210mm×297mm[백상지80g/㎡(재활용품)]9.8. 同行家属Are you travelling to Korea with any family member ?* 注：家属范围-配偶, 子女, 父母, 兄弟姐妹Note: Definition of a Family Member - your spouse, father, mother, children, brothers and sisters10. 访问经费/ FUNDING DETAILS（以下1—2项内容根据实际情况填写）10.1 访问经费(以美元为准) Estimated travel costs(in US dollars)＄200010.2 访韩费用支付者 Who will pay for your travel-related expenses ? (any person including yourself and/or institute)自费11. 填写申请表时是否接受过帮助/ ASSISTANCE WITH THIS FORM11.1 您在填写申请表时是否接受过别人的帮助？ Did you receive assistance in completing this form? （必须选择“否”）12. 誓约/ DECLARATION* 签证发给认定书持有者也须填写Those who possess confirmation of visa issuance must only complete section 1,2, and 12 of this form根据本人所知所信，我声明以上所有陈述均真实、准确、完整。

(第一页/ Page1)签证发给申请表APPLICATION FOR VISA*签证发给认定Confirmation No.?签证发给认定书持有者只需填写第1,10和12部分即可。

1. 个人信息/ PERSONAL DETAILS *手机Cell Phone No.PHOTO护照规格照片(35㎜×45㎜)6个月拍摄的正面免冠彩色相片，相片背景颜色须为纯白色Acol o rpho totake n w i t hi n l a st 6 mo nths(ful fa cew itho ut ha t, front view against white or off-whitebackground)1.1 护照上的英文名/Full name in English (as shown in your passport)姓／Family Name名／Given Names1.2 中文名字Chinese Name 1.3 性别／Sex男/Male[ ] 女/Female[ ] 1.4 出生日期Date of Birth (yyyy/mm/dd) 1.5 国籍Nationality1.6 出生国及出生地Country of Birth/Place of Birth 1.7 国家National Identity No.1.8您以前出境或入境国时是否使用过其他?Have you ever used any other names to enter or depart Korea?否No [ ] 是 Yes [ ] →如您选择"是"，请写具体容 If‘Yes’please provide details(姓Family Name , 名Given Name ) 1.9 您是否拥有双重国籍? Are you a citizen of more than one country ? 否No [ ] 是 Yes [ ]→如您选择"是"，请写具体容 If‘Yes’please write the countries ( )2. 访问信息/ DETAILS OF VISIT2.1 访目的 Purpose of Visit to Korea观光/通过 Tourism/Transit [ ] 参加会议/Meeting, Conference [ ] 医疗观光Medical Tourism [ ]短期商务Business Trip [ ]留学/研修Study/Training [ ]就业Work [ ]贸易/投资/驻在Trade/Investment/Intra-Corporate Transferee [ ]探亲VisitingFamily/Relatives/Friends [ ] 结婚移民Marriage Migrant [ ]外交/公务Diplomatic/Official [ ]其他Other [ ]→如您选择“其他”，请写具体容 If‘Other’please provide details ( )2.2 预定停留时间Intended Period of Stay 2.3 访预定日Intended Date of Entry2.4 国联系地址(包括酒店) Address in Korea(including hotels) 2.5 国联系Contact No. in Korea2.6 最近5年是否访问过国Have you travelled to Korea in the last 5 years ?否No [ ] 是 Yes [ ] →如您选择“是”，请写具体容 If‘Yes’please provide d e tails o f a n y t rips t o K ore a( ) 次times, 最近访目的Purpose of Recent Visit ( ) 2.7 最近5年是否访问过其他国家（国除外）Have you travelled to Korea in the last 5 years?否No [ ] 是 Yes [ ] →如您选择“是”，请写具体容 If‘Yes’please provide details of these trips国家 Name of Country (in English)访问目的 Purpose of Visit停留期间 Period of Stay (yyyy/mm/dd)~ (yyyy/mm/dd)印花税票粘贴处(签证票粘贴处)领事馆审核栏FOR OFFICIAL USE ONLY ?????????S D M???????????????????????????????????????????[ ]?[ ]???? (??)??/????/(??)??/1???/2.8.同行家属Are you travelling to Korea with any family member ? 无 No [ ] 有 Yes [ ]→如您选择“有”，请写具体容If ‘Yes’ please provide details of the family members you are travelling withFull name in English 出生日期Date of Birth(yyyy/mm/dd)国籍Nationality关系Relationship to you* 注：家属围-配偶, 子女, 父母, 兄弟姐妹Note: Definition of a Family Member - your spouse, father, mother, children, brothers and sisters3. 职业/ EMPLOYMENT3.1职业What are your current personal circumstances ?企业家Entrepreneur [ ]个体经营 Self-Employed [ ]工作者Employed [ ]公务员 Civil Servant [ ] 学生 Student [ ]退休者 Retired [ ]无职 Unemployed [ ] 其他 Other [ ]→如您选择“其他”，请写具体容 If‘Other’please provide details ( )3.2.职业详细信息Employment Detailsa) 单位/机构/学校（名称）Name of Company/Institute/School b) 职位/课程Your Position/Coursec) 单位/机构/学校（地址）Address of Company/Institute/School d) Telephone No.4. 邀请人信息/ DETAILS OF SPONSOR4.1邀请人/邀请单位Do you have anyone sponsoring you for the visa ?无No [ ] 有 Yes [ ] →如您选择“有”，请写具体容 If‘Yes’please provide detailsa) 邀请人/邀请单位 (名称) Name of your visa sponsor (Korean, foreign resident in Korea, company, or institute)b) 出生日期/营业执照 Date of Birth/Business Registration No. c) 关系Relationship to youd) 地址Address e) Phone No.5. 访问经费/ FUNDING DETAILS5.1访问经费(以美元为准) Estimated travel costs(in US dollars)5.2访费用支付者 Who will pay for your travel-related expenses? (any person including yourself and/or institute)a) /单位名称Name of Person/Company(Institute) b) 关系Relationship to youc) 支援容Type of Support d) 联系Contact No.6. 联系信息/ CONTACT INFORMATION6.1本国地址Address in Your Home Country6.2现居住地Current Residential Address *仅限于现居住地与本国地址不同者 / Write if it is different from the above address6.3Telephone No. 6.4电子E-mail6.5紧急联系人信息Emergency Contact Informationa) Full Name in English b) 居住国家Country of residencec) Telephone No. d) 关系Relationship to you7. 护照信息/ PASSPORT INFORMATION7.1 护照类型Passport Type外交护照Diplomatic [ ]公务护照Official [ ] 普通护照 Regular[ ]其他 Other [ ]→如您选择‘其他’，请写具体容 If‘Other’please provide details( )7.2 护照Passport No.7.3 护照签发国Country of Passport7.4 护照签发地Place of Issue 7.5 签发日期Date of Issue 7.6 护照有效期至Date Of Expiry7.7 您是否有其他的护照? Do you have any other valid passport ?否No [ ] 是 Yes [ ]→如您选择‘是’，请写具体容 If‘Yes’please provide detailsa) 护照类型 Passport Type 外交护照 Diplomatic [ ]公务护照 Official [ ]普通护照 Regular[ ]其他 Other[ ]b) 护照Passport No. c) 护照签发国Country of Passport d) 护照有效期至 Date Of Expiry8. 婚姻状况/ MARITAL STATUS DETAILS8.1 目前婚姻状况Current Marital Status已婚Married [ ]离婚 Divorced [ ]未婚 Never married [ ]8.2 配偶个人信息 *仅限于已婚者 If‘Married’please provide details of your spousea) 姓Family Name (in English) b) 名Given Names (in English)c) 出生日期Date of Birth (yyyy/mm/dd) d) 国籍Nationalitye) 居住地Residential Address f) 联系Contact No.9. 学历/ EDUCATION9.1 最终学历 What is the highest degree or level of education you have completed ?硕士/博士Ma st er’s/D oc toral D eg r e e [ ] 学士Bachelor’s Degree [ ]高中 High School Diploma [ ]其他 Other [ ]→如您选择“其他”，请写具体容 If‘Other’please provide details( )9.2 学校名称Name of School9.3 学校地址Location of School(city/province/country)10. 签证发给认定书签发信息/ DETAILS OF VISA ISSUANCE CONFIRMATION※仅限于在大民国出入国管理事务所·办事处收到签证发给认定书的人(Section 10 is only for those who possess confirmation of visa issuance issued by the Imm igration Office of the Republic of Korea)10.1 签证发给认定Confirmation No.10.2 签发日期Issue Date10.3 护照Passport No.10.4 护照有效期至Passport Expiry Date?签证发给认定书持有者只需填写第1,10和12部分即可。

(第一页/ Page1)签证发给申请表APPLICATION FOR VISA*签证发给认定号码Confirmation No.Have you ever used any other names to enter or depart Korea?否No [ ] 是 Yes [ ] →如您选择"是"，请写具体内容 If‘Yes’please provide details(姓Family Name , 名Given Name )1.9 您是否拥有双重国籍? Are you a citizen of more than one country ? 否No [ ] 是 Yes [ ]→如您选择"是"，请写具体内容 If‘Yes’please write the countries ( )→如您选择“其他”，请写具体内容 If‘Other’please provide details ( )2.7 最近5年内是否访问过其他国家（韩国除外）Have you travelled to Korea in the last 5 years?→如您选择“有”，请写具体内容If ‘Yes’ please provide details of the family members you are travelling with3. 职业/ EMPLOYMENT3.1职业What are your current personal circumstances ?如您选择“其他”，请写具体内容3.2.职业详细信息Employment Details4. 邀请人信息/ DETAILS OF SPONSOR4.1邀请人/邀请单位Do you have anyone sponsoring you for the visa ?无No [ ] 有 Yes [ ] →如您选择“有”，请写具体内容 If‘Yes’please provide details5. 访问经费/ FUNDING DETAILS5.1访问经费(以美元为准) Estimated travel costs(in US dollars)5.2访韩费用支付者 Who will pay for your travel-related expenses? (any person including yourself and/or institute)Address in Your Home Country6.2现居住地Current Residential Address *仅限于现居住地与本国地址不同者 / Write if it is different from the above address7. 护照信息/ PASSPORT INFORMATION7.1 护照类型Passport Type→如您选择‘其他’，请写具体内容 If‘Other’please provide details( )7.7 您是否有其他的护照? Do you have any other valid passport ?否No [ ] 是 Yes [ ]→如您选择‘是’，请写具体内容 If‘Yes’please provide details8.2 配偶个人信息 *仅限于已婚者 If‘Married’please provide details of your spouse9. 学历/ EDUCATION9.1 最终学历 What is the highest degree or level of education you have completed ?→如您选择“其他”，请写具体内容 If‘Other’please provide details( )‣签证发给认定书持有者直接移到第12部分(誓约)，填写以下空格后提交申请表(不用写第3~11部分)Those who have confirmation of visa issuance must move to section 12 (Declaration) to complete this from (Those with visa issuance confirmation must not fill out section 3~11).(第四页/ Page4) 11. 填写申请表时是否接受过帮助/ ASSISTANCE WITH THIS FORM12. 誓约/ DECLARATION* 签证发给认定书持有者也须填写Those who possess confirmation of visa issuance must only complete section 1,2, and 12 of this form 根据本人所知所信，我声明以上所有陈述均真实、准确、完整。