Full Name as Passport strictly

e.g. Surname then Given name

Date of Birth

e. g. 26011956 (no space and lines)

Sex
Country of Birth as Passport
State of Birth (no village / city / district)

e. g. Punjab

Race
Religion / Denomination
Marital status
Nationality
Passport Number
Passport Issuing Country
Passport issuing state (no village / city / district)

e. g. Punjab

Passport issuing date

e. g. 21032011 (no space and lines)

Passport expiry date

e. g. 20032015 (no space and lines)

PRC ID: (CHINA Citizen Only)

Country of Origin
State of Origin (no village / city / district)

e. g. Punjab

Prefecture/ Province of Origin

Address in Country of Origin
Nationality of Spouse
Occupation
Highest Qualification Attained

e.g. University/ Diploma/ Secondary/ Primary/ NA

Purpose of Visit

e.g. Tourism/ Visiting Relatives.

Date of Intended Arrival in Singapore

How long you intend to stay in Singapore

e. g. Up to 30 days

If your intended stay in Singapore is more than 30

days, please state the reason for your intended
length of stay and the duration.
Where will you be staying in Singapore
Singapore Address
Did you reside in other countries, other than your
country of origin, for one year or more during the
last 5 years
If YES, please provide details: Period of Stay?
Country? Address? From? To?
Have you ever been refused entry into or
deported from any country, including Singapore?
Have you ever been convicted in a court of law in
any country, including Singapore?
Have you ever been prohibited from entering
Singapore?
Have you ever entered Singapore using a
different passport or name?
If any of the answer is YES, please provide
details below
VISA delivery address (Only for Level-2 countries
applicant)

e.g. Hotel/ Relatives place/ Friends place