KINGDOM OF CAMBODIA

Nation Religion King

PHOTO
staple or glue photo here

VISA APPLICATION FORM

ROYAL EMBASSY OF CAMBODIA STANBUL / TURKEY

40 x 40

Please submit 1 copy with 1 photo and your passport Issuance Date: Expiration Date: Present Occupation: Home Address:

Passport Number: Place of Issuance (City/Country):

Surnames: First Name: Sex: Male Female

Marital Status Nationality: Date of Birth(dd/mm/yyyy): Place of Birth(City/Country): e-mail: Purpose of visit: Other (Please Specify) Date of entry to Cambodia (dd/mm/yyyy): Have you ever been to Cambodia? Yes No

Home Phone/Fax: Mobile Number: Business Address:

Work Phone/Fax:

Diplomatic

Touristic

Official

Business

Date of departure: Are you travelling with a Group tour? Yes Name of Organization / Person to be visited: No

At what address will you stay in Cambodia?

Surname Children under 12 years of age travelling with you

First name

Sex M F

Date of Birth(dd/mm/yyyy):

Relatives in the Kingdom of Cambodia

Relatives address:

For official use

Date of issue ..................................................................................... Visa # ................................................................................................ Visa type ........................................................................................... Date .......................... Month ............................... Year ....................

I hereby declare that the information on this form is true and correct Date (dd/mm/yyyy): ............................................... Applicants signature