Please Indicated Type of Visa Requested

Please attach
Photographs Diplomatic Visa
Official Visa
taken within
the last 6 months VISA APPLICATION FORM Courtesy Visa
Non-Immigrant Visa
front view
(3.5 x 4.5 cm) Ministry of Foreign Affairs of Thailand Tourist Visa
Transit Visa
Gratis Visa
Number of Entries Requested MULTI

Mr. Mrs. Master Miss BERNARD TABE TANYI

First Name Middle Name Last Name
(in BLOCK letters as appeared in the passport)
Former Name (if any)
Countries for which travel document is valid
Nationality CAMEROONIAN
ALL COUNTRIES
Nationality at Birth CAMEROONIAN
Purposed address in Thailand Bangkok -80/517 Soi Rak
Birth PlaceDOUALA - CAMEROONMarital Status MARRIED
Sinpong , Khwaeng Samae Dam, Khet Bang Khun Thian
Date of Birth 09/08 1987
Type of Travel Document ORDINARY PASSPORT
Name and Address of Local Guarantor
No. 0507959 Issued at BUEA
Date of Issue 31/08/2016 Expiry Date 31/08/2021
Occupation (specify present position and name of employer)
Tel./Fax.
TEACHER/ CAMEROON BAPTIST CONVENSION
Name and Address of Guarantor in Thailand
Luma Kwango Haddison
Current Address BAMENDA- NKWEN

Tel./Fax.
Tel. 00237675823637 E-mail edusec2003@yahoo.com
Permanent Address (if differnt from above) Signature Date
Attention for Tourist and Transit Visa Applicants :
I hereby declare that the purpose of my visit to thailand is for pleasure or transit
Tel. only and that in no case shall I engage myself in any profession or occupation
while in the country.
Names, dates and places of birth of minor children( if accompanying )
Signature Date 22/03/2018

FOR OFFICIAL USE

Application/Reference No.
Date of Arrival in and Departure from Thailand Visa No.
Type of Visa :
Diplomatic Visa Official Visa Courtesy Visa
Traveling by AIR PLANE Non-Immigrant Visa Tourist Visa Transit Visa
Flight No. or Vessel's name ET Category of Visa :
Duration of Proposed Stay 8 MONTHS Number of Entries :
Date of Previous Visit to Thailand 60/05/2018 Single Double Multiple Entries
Purpose of Visit : Tourist Transit Date of Issue Fee
Business Diplomatic/Official Expiry Date
Other(please specify) TEACHER Documents Submitted

REMARK : Applicant are required to pay a visa fee which is non refundable
regardless of whether the visa is approved or rejected. Authorized Signature and Seal