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Application for Schengen Visa
申根签证申请表
This application form is free
此表格免费
Family members of EU, EEA or CH citizens shall not fill in fields no.21, 22, 30, 31 and 32 (marked with*).
欧盟，欧洲经济区或瑞士联邦公民家属不填写第21,22,30,31及32项（*标注）
Fields 1-3 shall be filled in in accordance with the data in the travel document. 第1-3项须按
照旅行证件信息填写。
1. Surname (Family name): 姓氏:
FOR OFFICIAL USE ONLY
签证机关专用
Data złożenia wniosku:
Numer wniosku:
□w ambasadzie lub konsulacie
□we wspólnym ośrodku
przyjmowania wniosków
□u usługodawcy
□u pośredniczącego podmiotu
komercyjnego
□na granicy
Nazwa:
□inne
Wniosek przyjęty przez:
Dokumenty uzupełniające:
□dokument podróży
□środki utrzymania
□zaproszenie
□środek transportu
□podróżne ubezpieczenie
medyczne
□inne:
Decyzja o wizie:
□odmowa wydania wizy
□wiza przyznana:
□A
□C
□o ograniczonej ważności
terytorialnej
□Termin ważności:
Od …………………………….
Do …………………………….
Liczba wjazdów:
□ 1    □ 2    □ wielokrotny Liczba dni: ....................
2. Surname at birth (Former family name(s)): 出生时姓氏:
3. First name(s) (Given name(s)): 名字:
4. Date of birth
(day-month-year):
出生日期(日-月-年):
5.Place of birth:
出生地点:
6.Country of birth:
出生国:
7. Current nationality: 现国籍:
Nationality at birth, if different:
出生时国籍，如不同:
Other nationalities: 其他国籍:
8. Sex: 性别:
□ Male 男 □ Female 女
9. Marital status: 婚姻状况:
□ Single 单身 □ Married 已婚 □ Registered Partnership
注册伴侣关系    □ Separated 分居 □ Divorced 离异 
□Widow(er) 丧偶 □ Other (please specify): 其他（请注明):
10. Parental authority (in case of minors) /legal guardian (surname, first name, address, if different from applicant’s, telephone no., e-mail address, and nationality):
父母（如是未成年申请人）/合法监护人（姓名、住址，如与申请人不同)电话号码、及国籍: 
 
11. National identity number, where applicable: 公民身份证号码，如适用:
12.Type of travel document: 旅行证件类型:
□Ordinary passport 普通护照 □ Diplomatic passport 外交护照 □ Service passport 公务护照
□Official passport 因公护照 □ Special passport 特殊护照
□Other travel document (please specify) 其他旅行证件（请注明):
13. Number of travel document:
旅行证件号码:
14. Date of issue:
签发日期:
15. Valid until:
有效期至:
16. Issued by:
签发机关:
17. Personal data of the family member who is an EU, EEA or CH citizen:
accessible是什么意思中文
如有家庭成员为欧盟、欧洲经济区或瑞士联邦公民的，请填写该家庭成员的个人信息:
Surname (Family name): 姓氏:
First name(s) (given name(s)): 名字:
Date of birth:
出生日期（日-月-年):
Nationality: 国籍:
Number of travel document of ID card:
旅行证件或个人身份证件号码:

18.Family relationship with an EU, EEA or CH citizen:
申请人与欧盟，欧洲经济区或瑞士联邦公民亲属关系，如涉及:
□spouse 配偶 □ child 子女 □ grandchild 孙子女 □ dependent ascendant 赡养的老人
□registered partnership 注册伴侣关系 □ other 其他:
19. Applicant’s home address and e-mail address:
  申请人家庭住址及地址:
Telephone number(s): 电话号码:
20. Residence in a country other than the country of current nationality: 在现国籍以外国家居住:
□ No 否  
□ Yes 是 Residence permit or equivalent 居留许可或同等证件 ........................................
No. 号码..............................Valid until 有效期至.................................................
* 21. Current occupation: 现职业:
* 22. Employer and employer’s address and telephone number. For student, name and address of educational establishment: 工作单位的名称，地址和电话号码。如是学生，请填写教育机构名称及地址：
23.Main purpose(s) of the journey:  旅行目的:
□Tourism 旅游 □ Business 商务 □ Visiting family or friends 探亲访友 □ Cultural 文化
□Sports 体育    □ Official visit 官方出访 □ Medical reason 医疗 □ Study 学习              
□Airport transit 机场过境 □ Other (please specify) 其他（请注明):
24. Additional information on purpose of stay: 关于逗留目的的补充信息:
25. Member State of main destination (and other Member States of destination, if applicable): 主要目的地申根成员国 
（及其他目的地申根成员国，如适用):
26. Member State of first entry:
首入申根成员国:
27. Number of entries requested: 申请入境次数:
□ Single entry 单次    □ Two entries 两次    □ Multiple entries多次
Intended date of arrival of the first intended stay in the Schengen area: 在申根地区预计首次停留的预计抵达日期:
Intended date of departure from the Schengen area after the first intended stay: 在申根地区预计首次停留之后的
预计离开日期:
28. Fingerprints collected previously for the purpose of applying for a Schengen visa:
此前申请申根签证时是否有指纹记录:
□ No 否 □ Yes 是
Date, if known 日期，如知晓……………………..
Visa sticker number, if known 签证贴纸号码，如知晓 ………………………………………
29. Entry permit for the final country of destination, where applicable: 最终目的地国入境许可，如适用:
Issued by 签发机关……………………………………………………………………………………
Valid from 有效期自…………………………………………until 至 ………………………………
* 30. Surname and first name of the inviting person(s) in the Member State(s). If not applicable, name of hotel(s) or temporary accommodation(s) in the Member State(s): 申根成员国邀请人姓氏及名字。如不适用，
请填写在申根成员国酒店或暂住居所名称:
Address and e-mail address of inviting person(s)/hotel(s)/temporary accommodation(s): 邀请人/酒店/暂住居所地址及地址:
Telephone no.: 电话号码:

* 31. Name and address of inviting company/organisation: 邀请公司/机构名称及地址:
Surname, first name, address, telephone, telefax, and e-mail address of contact person in company/organisation:
邀请公司/机构联系人姓氏，名字，地址，电话号码及 地址:
Telephone and telefax of company/organisation:
邀请公司/机构:
* 32. Cost of travelling and living during the applicant’s stay is covered: 申请人旅费以及停留期间的生活费用由:
□by the applicant himself/herself
申请人自己承担
Means of support: 支付方式:
□Cash 现金
□Traveller‘s cheques 旅行支票
□Credit card 信用卡
□Prepaid accommodation 预付住宿
□Prepaid transport 预付交通
□Other (please specify): 其他(请注明):
□by a sponsor (host, company, organisation), please specify
由赞助人（邀请人，公司，机构）承担，请注明:     
.....................................
□referred to in field 31 or 32 30 or  31参见第30及31项
.....................................
□other (please specify) 其他（请注明）:
Means of support: 支付方式:
□Cash 现金
□Accommodation provided 预付住宿
□All expenses covered during the stay
支付旅行期间全部费用
□Prepaid transport 预付交通
□Other (please specify): 其他(请注明）:

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