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 1. 姓 SURNAME                                              漢字姓名

 2. 名 GIVEN NAMES

 3. 생년월일 DATE

    OF BIRTH

     年    月    日

 4. 性別

    SEX

 5. 國籍

    NATIONALITY

 6. 出生地 PLACE

    OF BIRTH

 7. 旅券PASSPORT種類CLASSIFICATION 番號NUMBER 發給日DATE OF ISSUE 滿了日DATE OF EXPIRY 發給處 ISSUED BY

    外交·官用·一般·其他

    DP    OF   OR

 8. 配偶者 姓名 및 國籍 SPOUSE'S NAME & NATIONALITY

 9. 職場 및 職位 OCCUPATION & TITLE                                                    電話番號 PHONE NO.

 10. 入國目的 PURPOSE OF ENTRY(EXPLAIN FULLY)

 11. 住所 PRESENT ADDRESS                                      電話番號 PHONE NO.

 12. 國內 滯留地 ADDRESS IN KOREA                                                     電話番號 PHONE NO.

 13. 滯留 連絡處 REFERENCES IN KOREA

 14. 滯留 豫定期間 DESIRED LENGTH OF STAY

 15. 訪韓事實 PREVIOUS VISIT IF ANY

 16. 同伴 家族

    ACCOMPANIED

    FAMILY

 國籍 NATIONALITY      姓名 NAME      性別 SEX    生年月日 DATE OF BIRTH

 17. 國內 滯留 家族

     FAMILY STAYING

     IN KOREA

 國籍 NATIONALITY      姓名 NAME      性別 SEX    生年月日 DATE OF BIRTH

  I declare that the statements made in this application are true and correct to the best of my knowledge

  and belief that I will observe the provisions of the Immigration Law of the Republic of Korea and that

  I will not engage in any activities irrelevant to the purpose of entry stated herein.

 申請日 DATE OF APPLICATION

 申請人署名 SIGNATURE OF APPLICANT

공    용    란    FOR OFFICIAL USE ONLY

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