Please attach2 photographstaken within

the last 6 months(3.5 x 4.5 cm)

APPLICATION FOR VISAMinistry of Foreign Affairs of Thailand

Please Indicate Type of Visa Requested

n Diolomatic Visan ornciat visan Courtesy VisanNon-trnrnierant VisanrouristviLn Transit Visa

Number of Entries Requested

! tvt. n vt.. ! vtiss

FormerName (rf any)

First Name MiddleName FamilyName (inBLocKletters)

Countries for which travel document is valid

Nationality

Proposed Address in ThailandNationality at Birth

Birth Place

Date of Birth

Marital Status

Name and Address of Local Guarantor

Type of Travel Document

No. Issued at

Date of Issue Expiry Date

Occupation (specify present position and name of employer)

Current Address

Tel. E-mail

Permanent Address (if dffirentfrom above)

Tel.

Names, dates and places of birth of minor children (if accompanying)

Date of Arrival in Thailand

Traveling by

Flight No. or Vessel's name

Duration of Proposed Stay

Date of Previous Visit to Thailand

Purpose of Visit: n Tourism n Transit

n Business n Diplomatic/Official

Tel.lFax.

Name and Address of Guarantor in Thailand

Tel./Fax.

I hereby declare that I will not request any refund frommy paid visa fee even if my application has been declined.

Signature Date

Attention for Tourist and Transit Visas ApplicantsI hereby declare that the purpose of my visit to Thailandis for pleasure or transit only and that in no case shall I engagemyself in any profession or occupation while in the country.

Signature Date -

FOR OFFICIAL USE mlavi.afttml0(ß2t07

Application/Reference No.

Visa No.

Type of Visa:

nDiplomatic VisanNon-Immierant Visa

I offi.iul viru n Courtesv visan to*irt viru Ü Tr*sit visa

Category of Visa:

Number of Entries:

n Singte f]Double n vt rltipl" nFeeDate of Issue

Expiry Date

Documents Submitted

Authorized Signature and Seal

Entries

n Other @lease specrfy)