"Bhutan Visa Application Form"

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VISA APPLICATION FORM FOR THE KINGDOM OF BHUTAN
(Please fill in block capital)
1.
Name in Full: _______________________________________________________
(Surname)
Passport
2.
Date of Birth: _________/_____________/________________(DD-MM-YYYY)
size Photo
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 No.________________________
8.
Occupation/Profession: ________________________________________________________________
9.
Period for which visa is required: from ______________________________to ___________________
(DD– MM–YYYY)
(DD– MM–YYYY)
10. Port of entry/exit: Entry Port ______________________ Exit Port _______________________________
11. Purpose of visit to Bhutan: _____________________________________________________________
12. Are you accompanying your spouse/parents/children?
Yes
No
If Yes, name of the spouse/parents/children ________________________________________________
13. Is this your first visit to Bhutan?
Yes
No
If No, give details of earlier visit(s)
__________________________________________________
__________________________________________________________________________________
I hereby declare that the statement given above is true and correct. I am aware that the Bhutanese immigration
laws do not permit me to indulge in any activity other than the one stated above. I fully understand that
providing false information to the Immigration Authorities or indulging in other activities would result in
cancellation of my visa and deportation thereof.
Date: _____________________________
Place: _____________________________
Signature of Applicant: _________________
For Official use only
Approved/Not Approved/Others _________________________________
Signature of the Approving Officer _______________________________
VISA APPLICATION FORM FOR THE KINGDOM OF BHUTAN
(Please fill in block capital)
1.
Name in Full: _______________________________________________________
(Surname)
Passport
2.
Date of Birth: _________/_____________/________________(DD-MM-YYYY)
size Photo
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 No.________________________
8.
Occupation/Profession: ________________________________________________________________
9.
Period for which visa is required: from ______________________________to ___________________
(DD– MM–YYYY)
(DD– MM–YYYY)
10. Port of entry/exit: Entry Port ______________________ Exit Port _______________________________
11. Purpose of visit to Bhutan: _____________________________________________________________
12. Are you accompanying your spouse/parents/children?
Yes
No
If Yes, name of the spouse/parents/children ________________________________________________
13. Is this your first visit to Bhutan?
Yes
No
If No, give details of earlier visit(s)
__________________________________________________
__________________________________________________________________________________
I hereby declare that the statement given above is true and correct. I am aware that the Bhutanese immigration
laws do not permit me to indulge in any activity other than the one stated above. I fully understand that
providing false information to the Immigration Authorities or indulging in other activities would result in
cancellation of my visa and deportation thereof.
Date: _____________________________
Place: _____________________________
Signature of Applicant: _________________
For Official use only
Approved/Not Approved/Others _________________________________
Signature of the Approving Officer _______________________________