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APPLICATION FOR VISA

. . [ ] . , . 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 selectOther, please provide us with more information in the given space.

1. / PERSONAL DETAILS

PHOTO

(3545)-

6

A color photo taken within last 6 months(full face without hat, front view against white or off-white background)

1.1 /Full name in English (as shown in your passport) Family Name Given Names

1.2 1.3 Sex /Male[ ] /Female[ ]

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

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).

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3. / PASSPORT INFORMATION3.1 Passport Type

Diplomatic [ ] Official [ ] Regular[ ] Other [ ]

IfOtherplease provide details ( )3.2 Passport No. 3.3 Country of Passport 3.4 Place of Issue

3.5 Date of Issue 3.6 Date Of Expiry

3.7 Do you have any other valid passport ? No [ ] Yes [ ] IfYesplease provide details a) Passport Type

Diplomatic [ ] Official [ ] Regular[ ] Other [ ] b) Passport No. c) Country of Passport d) Date Of Expiry

4. / CONTACT INFORMATION

4.1 Address in Your Home Country

4.1 Current Residential Address * / Write if it is different from the above address

4.3 Cell Phone No. 4.4 Telephone No. 4.5 E-mail

4.6 Emergency Contact Information a) Full Name in English b) Country of residence

c) Telephone No. d) Relationship to you

5. / MARITAL STATUS DETAILS5.1 Current Marital Status

Married [ ] Divorced [ ] Never married [ ]

5.2 * IfMarriedplease provide details of your spouse 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. / EDUCATION6.1 What is the highest degree or level of education you have completed ?

/ Masters/Doctoral Degree [ ] Bachelors Degree [ ] High School Diploma [ ] Other [ ]

IfOtherplease provide details ( )

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

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7. / EMPLOYMENT7.1 What are your current personal circumstances ?

Entrepreneur [ ] Self-Employed [ ] Employed [ ] Civil Servant [ ] Student [ ] Retired [ ]

Unemployed [ ] Other [ ] IfOtherplease provide details ( )

7.2. Employment Details a) // Name of Company/Institute/School

b) / Your Position/Course

c) // Address of Company/Institute/School

d) Telephone No.

8. / DETAILS OF SPONSOR8.1 / 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/Intra-Corporate Transferee [ ]

Visiting Family/

Relatives/Friends [ ] Marriage Migrant [ ]

/ Diplomatic/Official [ ] Other [ ]

IfOtherplease provide details ( )9.2 Intended Period of Stay 9.3 Intended Date of Entry

9.4 ( ) Address in Korea(including hotels)

9.5 Contact No. in Korea

9.6 5 Have you travelled to Korea in the last 5 years ? No [ ] Yes [ ] IfYesplease provide details of any trips to Korea ( ) times, Purpose of Recent Visit ( )9.7 5 Have you travelled outside your country of residence, excluding to Korea, in the last 5 years ? 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)

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(4 / Page4)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

Full name in English Date of Birth (yyyy/mm/dd)

Nationality Relationship to you

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

10. / FUNDING DETAILS10.1 ( ) Estimated travel costs(in US dollars)

10.2 Who will pay for your travel-related 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 FORM11.1 ? Did you receive assistance in completing this form? No [ ] Yes [ ] IfYesplease provide details of the person who assisted you

Full Name Date of Birth (yyyy/mm/dd) Telephone No.

Relationship to you

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. 761 [ 5]

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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. 91 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.

FOR OFFICIAL USE ONLY

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Application

Reception

Review

Approval

Issuance

Applicant

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Diplomatic Mission

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Diplomatic Mission

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Diplomatic Mission

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Diplomatic Mission

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