Foreigner's images Portrait photography* Passport data page image* Personal Information(PNR)Surname* (Use international character as in ICAO line) Date of birth (DD/MM/YYYY) * Full date,month and year Only year is known Email * Have you ever used any other passports to enter into Viet Nam? Do you have multiple nationalities? Violation of the Vietnamese laws/regulations (if any) Requested informatione-Visa request information Single - entry Multiple - entry Grant Evisa valid from (DD/MM/YYYY)* PASSPORT INRORMATIONIssuing Authority/Place of issue Expiry date (DD/MM/YYYY)* Do you hold any other valid passports? CONTACT INFORMATIONPermanent residential address Current residential address OCCUPATIONName of Company/Agency/School Position/Course of study: INFORMATION ABOUT THE TRIPPurpose of entry * Agency/Organization/Individual that the applicant plans to contact when enter into Viet Nam Name of hosting organisation Information about the trip Intended length of stay in Viet Nam (number of days) * Intended date of entry (DD/MM/YYYY) * Allowed to entry through checkpoint* Exit through checkpoint* Intended temporary residential address in Viet Nam* City/Province * Phone number (in Vietnam) Have you been to Viet Nam in the last 01 year? Do you have relatives who currently reside in Viet Nam? Under 14 years old accompanying child(ren) included in your passport (if any)Full name (First name Middle name Last name) Sex Date of birth (DD/MM/YYYY) Portrait photography Delete 1 Male Female 2 Male Female TRIP’S EXPENSES, INSURANCEIntended expenses (in USD) Who will cover the trip’s expenses of the applicant Does the applicant have health insurance arranged for their stay in Viet Nam? |
