法国签证表格 (1)

This application form should be filled out in English

此表格必须以英文填写

Schengen Visa Application form

申根签证申请表

1. Surname (Family name) (x) For official u only

姓氏

PHOTO

照片

This application form is free

此表格免费

签证机关专用

2. Surname at birth (Former family name (s) (x)

出生时姓氏

3. First name (s) (Given name (s) (x) Visa application number:

名字

4. Date of birth (day-month-year) Application lodged at

出生日期 (日-月-年)

5. Place of birth / 出生地 7. Current nationality / 现国籍

Date of application:

 Embassy/Consulate

 CAC Nationality at birth, if different:

 Service provider

 Commercial intermediary

 Border

Name:

 Other

File handled by:

Supporting documents:

 Travel document

 Means of subsistence

 Invitation

 Means of transport

 TMI

 Other:

6. Country of birth / 出生国

出生时国籍，如不同

 Married / 已婚 8. Sex / 性别 9. Marital status / 婚姻状况  Single / 未婚

 Male / 男  Female / 女

 Separated / 分居  Divorced / 离婚  Widow (er) / 丧偶

 Other / 其它 …………………………….

10. In the ca of minors: Surname, first name, address (if different from applicant’s) and nationality of parental authority /

legal guardian / 未成年人士须填上合法监护人的姓名、地址(如与申请人不同) 、及国籍

11. National identity number, where applicable

国民身份证号码，如适用

12. Type of travel document 护照种类：  Ordinary passport / 普通护照  Diplomatic passport / 外交护照

 Service passport / 公务护照  Official passport / 官员护照  Special passport / 特殊护照

 Other (plea specify) / 其它旅行证件（请注明）：……………………………………

13. Number of travel

document 旅行证件编号

14. Date of issue 签发日期 15. Valid until 有效期至 16. Issued by 签发机关

17. Applicant’s home address and e-mail address 申请人地址及电邮

Telephone number(s)

电话号码

Visa decision:

 Refud

 Issued

 A

18. Residence in a country other than the country of current nationality 是否居住在现时国籍以外的国家

 No 否

 Yes. Residence permit or equivalent …………………… No ………………… Valid until..…………………………..

是。 居留证 编号 有效期至

*19. Current occupation

现职业

*20. Employer and employer’s address and telephone number. For students, name and address of educational establishment.

工作单位名称，地址和电话，学生填写学校名称及地址

 C

 LTV

 Valid

From ………………………

Until ………………………

21. Main purpo(s) of the journey: 旅程主要目的

 Tourism / 旅游  Business / 商务  Visiting Family or Friends / 探亲访友

 Cultural / 文化  Sports / 体育  Official visit / 官方访问

 Medical reasons / 医疗  Study / 升学  Transit / 过境

 Airport transit / 机场过境

 Other (plea specify) / 其它 (请注明）

Number of entries:

 1  2  Multiples

Number of days:

(x) Fields 1-3 shall be filled in accordance with the data in the travel document

字段 1-3 须依据旅行证件填上相关资料

22. Member State (s) of destination / 目的地之申根国 23. Member State of first entry / 最先抵达的申根国

24. Number of entries requested 申请入境次数

 Single entry / 一次  Multiple entries / 多次

 Two entries / 两次

25. Duration of the intended stay or transit

Indicate number of days

预计逗留或过境日数

The fields marked with * shall not be filled by family members of EU, EEA or CH citizens (spou, child or dependent ascendan t) while exercising their right to

free movement. Family members of EU, EEA or CH citizens shall prent documents to prove this relationship and fill in fields No 34 and 35.

欧盟、欧洲经济区或瑞士公民的家庭成员(配偶、子女或赡养的老人)行使其自由往来的权利，不必回答带*的问题，欧盟、欧洲经济区或瑞士公民的

家庭成员必须根据字段 34 及 35 的数据提交证明其亲属关系的文件。

26. Schengen visas issued during the past three years / 过往三年获批的申根签证

 No / 没有

 Yes. Date (s) of validity from ………………………………………. to …………………………………………..

有。 有效期由 至

27. Fingerprints collected previously for the purpo of applying for a Schengen visa 以往申请申根签证有否指纹纪录

 No / 没有  Yes 有 …………………………………………………. Date, if known / 日期，如知道

28. Entry permit for the final country of destination, where applicable 最后目的地之入境许可

Issued by ………………….……...…………… Valid from ……………………………until ………………………………

签发机关 有效日期由 至

29. Intended date of arrival in the Schengen area 30. Intended date of departure from the Schengen area

预定入境申根国日期 预定离开申根国日期

*31. 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 States (s)

申根国的邀请人姓名。如不适用， 请填写申根国的

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/暂住居所的地址及电邮

Telephone and telefax 电话 及 传真

*32. Name and address of inviting company / organization Telephone and telefax of company /

提出邀请的公司或机构名称及地址 organisation 公司或机构的电话及传真

Surname, first name, address, telephone, telefax, and e-mail address of contact person in company / organisation

该公司/机构的联络人姓名、地址、电话、传真及电邮

*33. Cost of traveling and living during the applicant’s stay is covered

旅费以及在国外停留期间的生活费用

 by the applicant himlf/herlf / 由申请人支付

 by a sponsor (host, company, organisation), plea

Specify / 由赞助人支付，请注明

 referred to in field 31 or 32 / 参照字段 31 及 32

 other (plea specify) / 其它 (请注明)

Means of support / 支付方式

 Cash / 现金

 Traveller’s cheques / 旅行支票

 Credit card / 信用卡

 Prepaid accommodation / 预缴住宿

 Prepaid transport / 预缴交通

 Other (plea specify) / 其它(请注明)

Means of support / 支付方式

 Cash / 现金

 Accommodation provided / 提供住宿

 All expens covered during the stay / 支付旅程期间

所有开支

 Prepaid transport / 预缴交通

 Other (plea specify) / 其它(请注明)

34. Personal data of the family member who is an EU, EEA or CH citizen

家庭成员为欧盟、欧洲经济区或瑞士公民，请填上其个人资料

Surname First name(s)

姓氏 名字

Date of birth / 出生日期 Nationality / 国籍

Number of travel document or ID card

旅行证件或身分证编号

35. Family relationship with an EU, EEA or CH citizen 申请人与欧盟、欧洲经济区或瑞士公民的关系

spou child …….………………………. grandchild dependent ascendant

配偶 子女 孙儿女 受养人

36. Place and date / 地区 及 日期

37. Signature (for minors, signature of parental authority/legal guardian)

签署（未成年人由其监护人代签）

I am aware that the visa fee is not refunded if the visa is refud / 本人知道即使签证被拒也不能退还签证费

Applicable in ca a multiple-entry visa is applied for (cf. field No24): / 适用于申请多次入境签证 (参照字段 24)

I am aware of the need to have an adequate travel medical insurance for my first stay and any subquent visits to the territory of Member Status.

本人知道须预备有足够保额的旅游医疗保险作为首次及其后各次出发到申根国家领域之用

I am aware of and connt to the following: the collection of the data required by this application form and the taking of my photograph and, if applicable, the

taking of fingerprints, are mandatory for the examination of the visa application; and any personal data concerning me which appear on the visa application form,

as well as my fingerprints and my photograph will be supplied to the relevant authorities of the Member States and procesd by tho authorities, for the purpos

of a decision on my visa application.

Such data as well as data concerning the decision taken on my application or a decision whether to annul, revoke or extend a visa issued will be entered into, and

stored in the Visa Information System (VIS) (1) for a maximum period of five years, during which it will be accessible to the visa authorities and the authorities

competent for carrying out checks on visas at external borders and within the Member States, immigration and asylum authorities in the Member States for the

purpos of verifying whether the conditions for the legal entry into, stay and residence on the territory of the Member States are fulfilled, of identifying persons

who do not or who no longer fulfill the conditions, of examining an asylum application and of determining responsibility for such examination. Under certain

conditions the data will be also available to designated authorities of the Member States and to Europol for the purpo of the prevention, detection and

investigation of terrorist offences and of other rious criminal offences. The authority of the Member State responsible for processing the data is: Commission

Nationale de l'Informatique et des Libertés – 3, Place de Fontenoy – TSA 80715 – 75334 PARIS Cedex 07

I am aware that I have the right to obtain in any of the Member States notification of the data relating to me recorded in the VIS and of the Member State which

transmitted the data, and to request that data relating to me which are inaccurate be corrected and that data relating to me processing unlawfully be deleted. At my

express request, the authority examining my application will inform me of the manner in which I may exerci my right to check the personal data concerning me

and have them corrected or deleted, including the related remedies according to the national law of the State concerned. The national supervisory authority of that

Member State (Commission Nationale de l'Informatique et des Libertés – 3, Place de Fontenoy – TSA 80715 – 75334 PARIS Cedex 07 ) will hear claims

concerning the protection of personal data.

I declare that to the best of my knowledge all particulars supplied by me are corrected and completed. I am aware that any fal statements will lead to my

application being rejected or to the annulment of a visa already granted and may also render me liable to procution under the law of the Member State which

deals with the application.

I undertake to leave the territory of the Member States before the expiry of the visa, if granted. I have been informed that posssion of a visa is only one of the

prerequisites for entry into the European territory of the Member States. The mere fact that a visa has been granted to me does not mean that I will be entitled to

compensation if I fail to comply with the relevant provisions of Article 5(1) of Regulation (EC) No 562/2006 (Schengen Borders Code) and I am therefore

refud entry. The prerequisites for entry will be checked again on entry into the European territory of the Member States.

我知道并同意以下条款：必须提供本签证申请表上所收集的数据，包括我的照片、以及指纹样本，用作核实我的签证申请。本签证申请表上关于

我的任何个人资料，包括我的照片、以及指纹样本，将被提交给有关申根国家的相应机构，以便用于审理我的签证申请。 此数据将会连同有关申

请的批核决定以及废除、取消或延长已发签证的决定，一并输入在签证信息系统(VIS)(1)并储存最长五年，其间各签证部

门 、于各申根国边境及境内执行签证检查的法定部门、各申根国的移民局以及难民部门都有权使用有关数据，作为审查该人士是否符合资格合法

进入、逗留、或居住于申根国境，作为识别不符合或不再符合资格的人士，以及作为审查难民申请和决定负责机关谁属。于某些情况下，该数 据

将被开放予各申根国的特定部门以及欧盟警察组织，作为预防、侦查和研究恐怖袭击及其它严重罪案。负责处理数据的申根国部门是：法国国 家

信息和自主权委员会–3, Place de Fontenoy – TSA 80715 – 75334 PARIS Cedex 07。 当我的数据被错误更改以及该数据被不合法地删除，我知道自己

有权向输入本人数据至签证信息系统、传输有关我的数据、或要求取得有关我的 资料的申根国取得通知。如我明确请求，对我的申请进行审理的

使领馆会通知我，以何种方式可以行使核查有关我的个人资料并依据有关国家 法 律规定更改或消除错误数据、以及取得赔偿的权利。该申根国的

国家监督部门(法国国家信息和自主权委员会–3, Place de Fontenoy – TSA 80715 – 75334 PARIS Cedex 07

02)将会听取保障个人资料的要求。 我声明，就我所知，我提供的一切数据都是正确和完整的。我知道，任何虚假陈述都将导致拒绝签证或已发签

证的废止，也可以根据对我的申请 进行审理的申根国家的法律规定进行刑事追究。 如果签证申请被批准，我保证在签证到期前离开申根国家领土。

我获悉，拥有签证只是进入欧洲申根国家领土其中的一个条件，如果没有履行 欧 洲共同体公约562/2006之第五条第一款规定的条件而被拒绝入境，

那么仅仅拥有签证并不意味着我有权就此要求赔偿。在进入欧洲申根国家 的领 土时，入境条件将被再次审查。

Place and date / 地区 及 日期

Signature (for minors, signature of parental authority/legal guardian)

签署（未成年人由其监护人代签）

() In so far as the VIS is operational

1