[ 17 ]

( 1 / Page1)

APPLICATION FOR VISA

FOR OFFICIAL USE ONLY

(2 , 3 )

<>

[ ]
[ ]

< >
.
.
[ ] .
, .
<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 multiplechoice questions, you must check [] all that apply.
If you selectOther, please provide us with more information in the given space.

1. / PERSONAL DETAILS
1.1 /Full name in English (as shown in your passport)
PHOTO

(3545)

Family Name

Given Names

1.2

1.3 Sex
/Male[ ]

6

1.4 Date of Birth (yyyy/mm/dd)
Acolorphototakenwithinlast 6months(fullface
withouthat, front view against white or
offwhite background)

1.5 Nationality

1.6 Country of Birth

1.7 National Identity No.

1.8
Have you ever used any other names to enter or depart Korea?
No [ ] Yes [ ] IfYesplease provide details
( Family Name
, Given Name

1.9 Are you a citizen of more than one country ? No [ ] Yes [ ]

IfYesplease write the countries (

/Female[ ]

2. / DETAILS OF VISA ISSUANCE CONFIRMATION

(Section 2 is only for those who possess confirmation of visa issuance issued by the Immigration Office of the Republic of Korea)

2.1
Confirmation No.

2.2 Issue Date

2.3 Passport No

2.4 Passport Expiry Date

12 () (3 ~ 11 )
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).

3. / PASSPORT INFORMATION
3.1 Passport Type

Diplomatic [ ]
Official [ ]
Regular[ ]
IfOtherplease provide details (
3.2 Passport No.
3.3 Country of Passport
3.5 Date of Issue

3.4 Place of Issue

3.6 Date Of Expiry

3.7 Do you have any other valid passport ? No [ ]

IfYesplease provide details
a) Passport Type
Diplomatic [ ]
b) Passport No.

Other [ ]
)

Yes [ ]

Official [ ]
Regular[ ]
c) Country of Passport

Other [ ]
d) Date Of Expiry

4. / CONTACT INFORMATION
4.1 Address in Your Home Country
4.1 CurrentResidentialAddress* /Writeifitisdifferentfromtheaboveaddress
4.3 Cell Phone No.

4.4 Telephone No.

4.5 Email

4.6 Emergency Contact Information

a) Full Name in English

b) Country of residence

c) Telephone No.

d) Relationship to you

5. / MARITAL STATUS DETAILS

5.1 Current Marital Status
Married [ ]

Divorced [ ]

5.2 * IfMarriedplease provide details of your spouse

Never married [ ]

a) Family Name (in English)

b) Given Names (in English)

c) Date of Birth (yyyy/mm/dd)

d) Nationality

e) Residential Address

f) Contact No.

6. / EDUCATION
6.1 What is the highest degree or level of education you have completed ?
/ Masters/DoctoralDegree [ ]
High School Diploma [ ]

Bachelors Degree [ ]
Other [ ]

IfOtherplease provide details (

6.2 Name of School

)
6.3 Location of School(city/province/country)

7. / EMPLOYMENT
7.1 What are your current personal circumstances ?

Entrepreneur [ ]
SelfEmployed [ ]
Civil Servant [ ]
Student [ ]
Unemployed [ ]
Other [ ]
IfOtherplease provide details (
7.2. Employment Details
a) // Name of Company/Institute/School
c) // Address of Company/Institute/School

Employed [ ]
Retired [ ]
)
b) / Your Position/Course
d) Telephone No.

8. / DETAILS OF SPONSOR
8.1 / Do you have anyone sponsoring you for the visa ?
No [ ] Yes [ ] IfYesplease provide details
a) / Name of your visa sponsor (Korean, foreign resident in Korea, company, or institute)
b) / Date of Birth/Business Registration No.

c) Relationship to you

d) Address

e) Phone No.

9. / DETAILS OF VISIT
9.1 Purpose of Visit to Korea
/ Tourism/Transit [ ]

/Meeting, Conference [ ]

Medical Tourism [ ]

Business Trip [ ]

/ Study/Training [ ]

Work [ ]

// Trade/Investment/IntraCorporate
Transferee [ ]

V i s i t i n g
F a m i ly / R e l a t i v e s/ F r i e nd s [ ]

Marriage Migrant [ ]

/ Diplomatic/Official [ ]

Other [ ]

IfOtherplease provide details (

9.2 Intended Period of Stay
9.4 ( ) Address in Korea(including hotels)

)
9.3 Intended Date of Entry
9.5 Contact No. in Korea

9.6 5 Have you travelled to Korea in the last 5 years ?

No [ ] Yes [ ] IfYesplease provide detailsofanytripstoKorea
(
) times, Purpose of Recent Visit (
)
9.7 5 Haveyoutravelledoutsideyourcountryofresidence,excludingtoKorea,inthelast5years?
No [ ] Yes [ ] IfYesplease provide details of these trips
Name of Country (in English)

Purpose of Visit

Period of Stay

(yyyy/mm/dd)~ (yyyy/mm/dd)

9.8. Are you travelling to Korea with any family member ?

No [ ] Yes [ ] If Yes please provide details of the family members you are travelling with

Date of Birth
Full name in English
Relationship to you
Nationality
(yyyy/mm/dd)

* : , , ,
Note: Definition of a Family Member your spouse, father, mother, children, brothers and sisters

10. / FUNDING DETAILS

10.1 ( ) Estimated travel costs(in US dollars)
10.2 Who will pay for your travelrelated expenses ? (any person including yourself and/or institute)
a) /() Name of Person/Company(Institute)

b) Relationship to you

c) Type of Support

d) Contact No.

11. / ASSISTANCE WITH THIS FORM

11.1
Date of Birth Telephone Relationship to you
(yyyy/mm/dd) No.

?
Did you
receive
assistance
in
completing
this form?
No [ ]
Yes [ ]

IfYesplease
provide
details of the
person who
assisted you
Full
Name

12. / DECLARATION
*
Those who possess confirmation of visa issuance must only complete section 1,2, and 12 of this form

.
.
I declare that the statements made in this application are true and correct to the best of my knowledge and belief, and that I will comply with the Immigration Act of the
Republic of Korea.
(. . ) DATE OF APPLICATION (yyyy/mm/dd)
/
/
/
SIGNATURE OF APPLICANT

17
Signature of Parent or Legal Guardians for a person under 17 years of age

ATTACHMENT

1. 76 1 [ 5]

Notice
1. .
If extra space is needed to complete any item, record on a separate sheet of paper or submit relevant documents which could support your application.
2. ,
.
If you received Korean visa approval, and have new passport issued thereafter in lieu of lost/damaged passport, you must notify the concerned visa office of
changes in your passport information.
3. .
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.
4. 9 1 C .
Please note that category C visa holders are not able to change their status of stay after their entry into the Republic of Korea in accordance with Article 9(1) of the Enforcement
Regulations of the Immigration Act.

< >

Application

Applicant

Reception

()
Diplomatic Mission

210mm297mm[ 80g/()]

Review

()
DiplomaticMission

Approval

()
Diplomatic Mission

Issuance

()
Diplomatic Mission