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Visa Application Form - Ministry of Foreign Affairs

VISA APPLICATION FORM FOR KINGDOM OF BHUTAN (Please fill in block capital) 1. Name in Full: _____ (Surname)

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Text of Visa Application Form - Ministry of Foreign Affairs

VISA APPLICATION FORM FOR KINGDOM OF BHUTAN (Please fill in block capital) 1. Name in Full: ________________________________________ ________________ (Surname) 2. Date of Birth: ____________________________ (Day) (Month) (Year) 3. Sex : Male Female Marital Status: Married Single 4. Nationality : ________________________________________ ____ 5. Passport No: _______________________ Place of issue: ____________________ Date of Issue: ___________________ Valid until: ________________________ (DD MM YYYY) (DD MM YYYY) 6. Nature of Passport: Diplomatic Official Ordinary UN Laissez Passer 7. Permanent Address: ________________________________________ ______________________________ ________________________________________ __________Tel 8. Occupation/Profession: ________________________________________ ________________________ 9. Period for which visa is required: from___________________ to ______________________ (DD MM YYYY) (DD MM YYYY) 10. Port of entry/exit into Bhutan: Entry Port____________________ Exit Port ______________________ 11. Purpose of visit to Bhutan:_________________________________ _______________________ _____ 12. Is this your first visit to Bhutan? Yes No If No, give details of earlier visit ________________________________________ ________________________________________ ____ ________________________________________ ________________________________________ ____ I hereby declare that the statement given above is true and correct. I fully understand not to indulge in any activity which, are inconsistent with the purpose for which I have stated above. I understand that the period of stay to be granted is decided by the Bhutanese Immigration Authorities upon my arrival. Date : __________________ Place: _________________ Signature of Applicant ________________ For Official use only Type of Visa :____________________________ Visa Number :____________________________ Date of Issue : ___________________________ Visa Clearance No. : ___________________________ Attach passport size Photograph ( x cm)

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