编辑: 施信荣 2019-07-02

13688888888 d) 关系 Relationship to you 妈妈 (第三页 / Page3) 7. 护照信息 / PASSPORT INFORMATION 7.1 护照类型 Passport Type 外交护照 Diplomatic [ ] 公务护照 Official [ ] 普通护照 Regular[ V ] 其他 Other [ ] → 如您选择'其他',请写具体内容 If'Other'please provide details ( ) 7.2 护照号码 Passport No. E12345678 7.3 护照签发国 Country of Passport 中国 7.4 护照签发地 Place of Issue 广东 7.5 签发日期 Date of Issue 2015年1月1日7.6 护照有效期至 Date Of Expiry 2025年1月1日7.7 您是否有其他的护照? Do you have any other valid passport ? 否No [ V ] 是Yes [ ] → 如您选择'是',请写具体内容 If'Yes'please provide details a) 护照类型 Passport Type 外交护照 Diplomatic [ ] 公务护照 Official [ ] 普通护照 Regular[ ] 其他 Other [ ] b) 护照号码 Passport No. c) 护照签发国 Country of Passport d) 护照有效期至 Date Of Expiry z 8. 婚姻状况 / MARITAL STATUS DETAILS 8.1 目前婚姻状况 Current Marital Status 已婚 Married [ V ] 离婚 Divorced [ ] 未婚 Never married [ ] 8.2 配偶个人信息 *仅限于已婚者 If'Married'please provide details of your spouse a) 姓Family Name (in English) 高GAO b) 名Given Names (in English) 三SAN c) 出生日期 Date of Birth (yyyy/mm/dd) 1900年0月0日d) 国籍 Nationality 中国 e) 居住地 Residential Address 韩国首尔 f) 联系电话 Contact No. 010-9999-9999 9. 学历 / EDUCATION 9.1 最终学历 What is the highest degree or level of education you have completed ? 硕士/博士 Master's/Doctoral Degree [ ] 学士 Bachelor's Degree [ V ] 高中 High School Diploma [ ] 其他 Other [ ] → 如您选择"其他",请写具体内容 If'Other'please provide details ( ) 9.2 学校名称 Name of School 中山大学 9.3 学校地址 Location of School(city/province/country) 广州市海珠区新港西路135号10. 签证发给认定书签发信息 / DETAILS OF VISA ISSUANCE CONFIRMATION 仅限于在大韩民国出入国管理事务所・办事处收到签证发给认定书的人 (Section

2 is only for those who possess confirmation of visa issuance issued by the Immigration Office of the Republic of Korea) 10.1 签证发给认定号码 Confirmation No. 10.2 签发日期 Issue Date 10.3 护照号码 Passport No. 10.4 护照有效期至 Passport Expiry Date ? 签证发给认定书持有者直接移到第12部分(誓约),填写以下空格后提交申请表(不用写第3~11部分) Those who have confirmation of visa issuance must move to section

12 (Declaration) to complete this from (Thos e with visa issuance confirmation must not fill out section 3~11). (第四页 / Page4) 11. 填写申请表时是否接受过帮助 / ASSISTANCE WITH THIS FORM 11.1 您在填写申请表时是否接受过别人的帮助?Did you receive assistance in completing this form? 否[ V ] No 是Yes [ ] → 如您选择"是",请写具体内容 If'Yes'please provide details of the person who assisted you 姓名 Full Name 出生日期 Date of Birth (yyyy/mm/dd) 联系电话 Telephone No. 关系 Relationship to you 12. 誓约 / DECLARATION * 签证发给认定书持有者也须填写 Those who possess confirmation of visa issuance must only complete section 1,2, and

12 of this form 根据本人所知所信,我声明以上所有陈述均真实、准确、完整.我将遵守大韩民国的出入境管理法律法规. 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. 申请日期 (年月日) DATE OF APPLICATION (yyyy/mm/dd)

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