马来西亚签证表
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A．申请人详情PARTICULARS OF APPLICANT 1.全名（大写字母）
Full Name (Capital Letter)
2.性别Gender □男M □女F
3.出生地
Place/Country of Birth
4.出生日期Date of Birth (日Day/月Month/年Year)
5.国籍
Nationality
6.职业Occupation
7.婚姻状况
Marital Status
□单身Single dfs□已婚Married
□离婚Divorced□其他Others
8.住址Address 9.电话号码Tel No
B．护照详情PARTICULARS OF PASSPORT/TRA VEL DOCUMENT
10.护照种类
Travel Document 11.护照号码
Passport Number
12.签发地
Place/Country of Issue 13.有效期
Expiry Date
C．担保人详情PARTICULARS OF SPONSOR IN MALAYSIA （仅限多次往返ONLY FOR MEV APPLICA TION）14.全名（大写字母）
Full Name(Capital Letter)
15.身份证/护照号码
Identity Card/Passport No. 16.电话号码Tel No
17.住址
Address
D．申请详情DETAILS OF APPLICA TION
18.预计入境马来西亚日期
Estimated date of travel
to Malaysia ` （日Day/月Month）
19.预计停留时间
Estimate Duration of Stay
（日Day）
20.旅行目的
Purpose of Stay □观光/休闲Sightseeing/Leisure □过境Transit□商务Business □留学Study □访亲友Visiting Friends/Relatives□会议Conference □官方Offcial Visit
□就业Employment □其他Others （Specify）
21.申请签证类型
Type of Visa
Single Entry单次入境□Multiple Entries多次入境□（）E．其他OTHERS INFORMA TION
A．是否有被拒绝进入马来西亚Have you ever been prohibited from entering Malaysia：
B．是否有被遣送出马来西亚Have you ever been prosecuted in Malaysia：
C．是否有在马来西亚犯罪记录Have you ever committed an offence in Malaysia：
D．是否有任何有效的马来西亚签证Any valid Malaysia visa/permit：
E．是否护照有任何的涂改或破损Whether there is any altered passport．or damage in any way：是Yes□否No□是Yes□否No□是Yes□否No□是Yes□否No□是Yes□否No□
F．重要事项DECLARATION BY APPLICANT(IMPORTANT)
我特此声明并确认，我的护照在进入马来西亚时有至少六个月有效期
I hereby acknowledged and confirmed that my passport validity is at least six months upon arriving Malaysia．
我已阅读并理解此表所有问题，并对填表内容的真实性和准确性负责，我理解签证种类、有效期及停留期将由使领馆决定，任何信息不实、误导或填写不完整，均可能导致签证申请被拒绝或拒绝进入马来西亚。
I have read and understood all the questions in this application form and declared all information given are correct and true．I understand that the outcome of my application will be decided by Embassy/Consulate General of Malaysia．Any false．misleading or incomplete statement may result in rejection to my application．
申请人/担保人签名Signature of Applicant/Sponsor ________________
日期Date ________________。
