wm saigaely Aee8 (ea) ai7eAi4l) (1% / Paget) MBSR APPLICATION FOR VISA ASOIS Arlo Z7isio} mHSIwiO| Aafstal AaiAte SpessHo{oF AILICh > AlgiAidlol 2E Sol diet GME te se eteow 7iAFsfolor ect > MSAehe HE ZH) Slo y ALE SHAI2] wiRILICh > TIEY SMES OS, Mls 7/mRHAI7) BIEL. ‘iow to 1111 out this form > You must fil! out this form completely and correctly. > You must write in block letters efther in English or Korean. > For multiple-choice questions, you must check [1] all that apply. > If you select ‘Other’, please provide us with more information in the given space 1.1 of@ol 7148! Q 4181 /Full nane in English (as shom in your passport) oftgy |S Family Nine & Given Hanes wt Sa Se 2 - a Sid one g2 ao jgoe 1.2 ORG eR 1.3 SE Sex eave ovo ‘eesMlaiel ] of8/Fenalel } Baer wo! ‘cor pet tata win a4 ERR Date of Birth Gyro 1.5 3% Nationality Se mented fo wha oe ante bectgeen 1.6 S37F Cautry of Birth 1.7 S7KIESEE National laentity Wo. 18 0lMol Ho] SURIVS wh CE AIS AlSwerl oF Have you ever used any other nanes to enter or depart Korea? OMS Nf] Of Yes | + “Ol M4 Al ALES 71M IT ‘Yes’ please provide details (1 Family Nane Given Nane ) 1.9 3 BA Of Are you a citizen of more than one country? OMZ Nol ] of Yes{ J Oy AIL AL AALS 2/94 If Yes’ please write the countries ( 2A NBURSES aie BA) 22 wae teen uae! 24 Confireation No. 2.3 CALLS Passport No, 2.4 Of74e1# Pasgort Bry Date ASHSUSME WSS ABS H(ANSS OSsol Hee IA AAS - eS i we) ‘Those who have contirnation of visa issuance must nove to sect ion 12 (Declaration) to complete this fron (Those with visa issuance confirmation aust not fill out section 3-11) 210mm 297an[ 4) 80n/w (AEB)(12% | Page2) 8.1 GASH Passport Tyoe ‘918 Diplomatic (| 1 ‘71S! AMMLAS If ‘Other’ please provide details ( 3.2 HBS Passport No. 3.3 SBS7E Oountry of Passport ‘BB Official ( et Regular] 7184 Other [ ) 3.4 WEA Place of Issue 1 3.5 SRA Date of Issue 3.6 71ZIBLBE! Date OF Ewiry 3.7 CHE O18 2A] CHS Do you have any other valid passport ? > ‘ol MEAL AMIS IML It Yes! a) }815- Passport Type ‘91322! Diplonatic ( ) O4Bf8IS Passport No. OMS Wo [ please provice detal is 1 ol Yes 1 1 ie Other [ ) 7i2ISHEG Date OF Expiry 4.1 BS} A Address in Your Howe Countr 1 #8 Official [| eh Regul ©) BBR Country of Passport lar 1 4.4 81 AFA current Rosesntial Aacross «8! AARAIE BS 29: CHE 21 7Im/ Write ft is dfferent fron the ebove asress 4.3 FAIRS colt Phone No 4.4 SIEHSISt Toleshone No 4.5 01M Email 4.6 WIAA GEER for gency Contact Information ~~ a) 8 Full Nene in English b) AF7F Country of residence ©) SBS Telephone No ) BAI Relationship to you 5.1 Gal SIA! Current Warital Status Pie Martied {1 5.2 SPA OMAR -7IOR E718 APOICE ZIM It war Ol Divorced { J lt" please provide details of your pause Ol Never married (J ‘) Fanily Nane (in English) b) @ Given Nanos (in Erglish) ©) MBBw Date of Birth (yyyy/an/ée) @) 3 Nationality ©) AFAl Residential Address 1) SABEAL Contact No. 6.1 SIS What is the highest degree or level of educat ion you have completed ? AMAIA! Master's/Doctoral Degree {_— ] "4B Bachelor's Degree DB High School Diplona [| ] Piet Other [J ] + ‘2|Eh MB Al ALMLNG IAI If ‘Other’ please provide details ( 6.2 SIG Nene of Schoo! [6.3 Sil 7H) Location of School(city/province/cauntry) ai 207mm APR) Bay AEE |(3% / Pages) 7.1 AQ what are your current personal circumstances 7 AfQ{7b Entropreneur { ] AGAMA Selt-Enployed [ Awe Employed [] BPH civil Servant |] ‘ta Student [ SIVA Retired [1] +F5| Unemployed (1 let other [J] > 7IEF M8 Al AAS 71a IT ‘Other’ please provide details ( ) 7.2. AQ AMA Enploynent Details @) SIA}/7181/12081 Nano of Conpany/ insti tute/Schoo! b) 5191/398 Your Position/Course ©) SIA}/7|B1/81a2 FA Address of Conpery/Institute/Schoo| «d) BERIT Telephone No. 8.1 £8eI/ZAAt Do you have anyone sponsor ing you for the visa ? OMS Nol] Of Yost] > Ol MO Al SAIS Ziad IT please provide datai ls 2) BAG/ARSIAG Nano of your visa sponsor (Korean, foreign resident in Korea, company, or institute) b) BE WA/AAAS SUS Date of Birth/Business Registration No. ‘) BA Relationship to you FH heros: @) BRRAE Phone No 9.1 LBS Purpose of Visit to Korea ‘BB/B3} Tourisa/Trensit [ ] WAH /Meeting, Conference [ ] HB Medical Tourism [ ] 271888 ausiness Trip |] A/8 Stuay/Taining [| AMS Work (1) FORA Tradl Imvesteent/intra~ yee sce aye j Corporate Transteree [1 78 SE SABE Visiting Family Bole harriage Migrant 21/3 DiplomaticfOtticlal [1 let otter (1 + IEF MY Al SALAS I ‘Other’ please provide details ( ) 9.2 AHOTEIP|E Intended Period of Stay 0.3 Q1FO1GW Intended Date of Entry 9.4 AHOIEAI(S@ Fe) secress in Korea nclosig hotels) 9.5 G5 Uy GEER Contact No. in Korea 9.6 217] SUZ! HRS YE AS Have you travel led to Korea in the last 5 years 7 OMS NoL |] ol Yes( ] > ‘ol’ 8} Al AILS 7/34 If “Yos’ please provide dotalls of ary trips to Korea () 8 tines, 812 BESS Purpose of Recent Visit ( ) 9.7 83 Ol2ho| Dp1 SLIZI OFS S7F Have you travelled cus your cuntry of reside, ecluting to Korea, in the last 5 yeers 7 OM No{ ] Of Yes, ] — “al 4 A) LAINE 71 It ‘Yes’ please provide details of these trips 225 pur ‘WEL Period of Sta 78 Nano of Country (in English) | BES Purpose of Visit Bra Pegs 20mm 287mm 4822) B0gf af 74S)(4% J Pages) 9.6. Seals 71S FF AIA Are you travelling to Korea with any family menber 7 OHS No] Of Yes [J > “Ol SS Al AMHLES It Yes! pleas provide cbtails of the fanily menbers yu ave traveling with MGY Date of Birth ay ‘24 Full name in Exglish (ronal) Nationality 2A Relationship to you + Sa: 71821 WA - EA, i, FS, BM Note: betinition of a Fanily Momor'~ your speuse, tathar, nother, children, brothers and sisters 10.1 BHEZw|(O1S Gel 7|) estimated travel costs( in US dol ars) 10.2 AUIALSAt tho will pay for your travel-related expenses 7 (any person including yourself and/or institute) a) 134/81A1( G81) Nene of Person/Conpany Institute) ) lal Relationship to you ©) A1BILHS Type of Support d) 2134 Contact No 11.1 0] AMME AstSu] CHE Agie| SBS ELSI? Did you receive assistance in completing this form? OMS Wo] ol Yes] > ‘oi’ AE Al AIAIUIS If Yes’ please provide details of the person who assisted you “MBE Date of Bith za (vv) Relationship to you 89 Ful Name 48481 Telephone No. Bele 0 AMAol 7lalel USO! 712 Rol Assi sles HelsHuch. est Sols astlse] Seis Bald WIS Bee 2s setech. | declare that the statements nade in this application are true and correct to the best of ay knowledge and belief, ‘and that | will comply with the Immigration Act of the Republic of Korea ‘AIAIRIAE (le. DATE OF APPLICATION (yyyy/nm/da) red 1821 HEF SIOWTUE OF APPLICANT {7A OlSIXS| Be BO SE WASZele| Ma Signature of Parent or Legal Guardian's for a person under 17 years of age een vow | * SUS8N AWS, avoxAe ae (HE 6) owas B aAE 210nn> 287mnl 431%) 80a we (AES) ]1. 9 71a} BsIo} WMO USS WS ASL Be MAE PIE Mee > USuch If exva space is needed to complete ary item, record on a separate sheet of paper or submit relevant documents which could support your application. 2 Ube AEG Sc! FEA SE Me Sol NGS OE Me WES APOE, ee SUE He > USER Bae Ofgem AlBReI7IaoL Ee e}OHOF BIL. It you received Korean visa approval, and have new passport issued thereafter in lieu of ost/damaged passport, you must notity the concemed visa office of changes in your passport information. 3, ABS WAWSIAIS HOUR SIF A| IAF AIR) AY BOLE AEIROZS| go] si7Isx ge > Nach. Possession of a visa does nt entite the beara to enter the Republic of Korea upon artval at the port of enty i he/she Is found inadmissible 4. HARA AMA, MOEA HOl Wet CAL ABSA BR Fo AAAS Mae ¢ aout Pease note that catogory C visa holders are not able to change thor status of stay after their erty into the Republic of Korea in accordance wih Article S(t) of the Enforcement Regulations of the immigration Act. iA | ALAN ARIE ABeR ele - (281, 981 O14!) asa | een asus ela} ‘aiziatst | eiztalat aus BAAN aS JEL | aa et] < Peele) Baer > aa 5 aa AB wa Aeplation pectin Review seer! Issuance ‘aged A el 71 wi 221 HeLa Hel 71 fet (aaiza) (33) (38) (a8) ‘Seplom Diplonat ic Wission Diplomatic Mission Diplonat ic Mission Diplomatic Mission 21Ommx297mm{M4AI%1 BOo/er (48S H)]