(Form No.

)
APPLICATION FOR VIETNAMESE ENTRY VISA
M3
1. Name and Surname (In block letter, as stated in passport):
01 passport-size
Name Photo
(with face
straight
forward)
Surname
attached here

2. Date of birth: / / 3. Sex: Male / Female

day/month/ year
4. Place of birth: 5. Nationality at birth:
Present nationality:

6. Passport No. : Kind of passport:  Diplomatic/  Official / 

Normal

Date of issue: Expiry Date: Issued by:

7. Profession: Name of your company/organization:

Mobile No.:
8. Present home address in your country:

Telephone/Mobile No: Email address:

9. Purpose of entry and exit 10. Name, address of office, organization or full
(business/conference/tourist/visiting name, relation, address of your relatives to
relatives/training course/market survey, etc.) contact or visit while in Vietnam (name, address
& telephone of hotel if for tourist purpose):

12. Number of Entry & exit:

11. Proposed duration of stay in Vietnam:……..days
 Single /  Multiple
From (entry date of Vietnam) ………..to (exit date of Vietnam)
…………..
13. Port of arrival: Port of departure:
14. Have you been in Vietnam before?
No Yes If yes, the date of your last visit to Vietnam:
I swear the above declarations are true for which I shall take responsibility.
VISA No (for official use only) Done at on
Signature