Visa Form

Please attach 2 photographs taken within the last 6 months (3.5 x 4.5 cm)

_{APPLICATION FOR VISA}

_{Royal Thai Embassy, Dhaka}

_{Please Indicate Type of Visa Requested}

_{□                                                                                          Diplomatic Visa}

_{□     Official Visa}

_{□     Courtesy Visa}

_{□     Non-Immigration Visa}

_{□     Tourist Visa}

_{□     Transit Visa}

_{Number of Entries Requested}                                                        

_{□                                                                                             Mr. □ Mrs. □ Miss                                                                                                                                                                                                                                                                                                    First Name                                                                                                                     Middle Name                                                  Family Name                          (in Block letters)}

_{Former Name (if any)                                                                                                Countries for which travel document is valid}                            

_Nationality                                                                                                                                                                                                       

_{Nationality at Birth                                                                                                   Proposed Address in Thailand}                                                

_{Birth Place                                   Marital Status                                      _}                                                                                                       

_{Date of Birth                                                                                                            Name and Address of Local Guarantor}

_{Type of Travel Document                                                                                              No.                                            Issued at}                                                                                                                                                                 

_{Date of Issue                                          Expiry Date                                     Occupation (specify present position and name of employer)}

_{Tel./Fax.                                                                                                    Name and Address of Guarantor in Thailand}                                            

                                                                                                                                                                                                                                                                                                                      

                                                                                                                                                                                                                                                                                                                      

_{Current Address}

_Tel.

_E-mail

_Tel./Fax.

_{I hereby declare that I will not request any refund from my paid visa fee even if my application has been declined.}

_{Signature                                                   Date}                                        

Attention for Tourist and Transit Visas Applicants I hereby declare that the purpose of my visit to Thailand is for pleasure or transit only and that in no case shall I engage myself in any profession or occupation while in the country. Signature                               Date

_{Permanent Address (if different from above)}                                                         

                                                                      _{Tel.                                    Names, Dates and Places of Birth of minor children}

_{(if accompanying)}                                                                                                                                       

FOR OFFICIAL USE Application/Reference No.                                        Visa No.                                                                     Type of Visa: □  Diplomatic Visa             □ Official Visa    □ Courtesy Visa □  Non-Immigration Visa □ Tourist Visa     □ Transit Visa Category of Visa:                                                                               Number of Entries: □  Single   □ Double   □ Multiple   □       Entries Date of Issue                                     Fee                                          Expiry Date                                                                                        Documents Submitted                                                                                                                                                                                 Authorized Signature and Seal

_{Date of Arrival in Thailand                                                                             Traveling by                                                                                      Flight No. or Vessel Name}                                                                           

_{Duration of Proposed Stay}                                                                          

_{Date of Previous Visit to Thailand                                                                  Purpose of Visit:  □ Tourism    □ Transit   □ Business}

_{□     Diplomatic /Official   □ Other (please specify)}                                                                                        

FOR OFFICIAL USE ONLY □UG □PP □AF □RD □ Multiple □ Other                                                                                                            □GPV □CAF □STH □SES □FIT □GPT □GFL □NRR □ Other                                                                           □FVP □IAF □FP □NF □OT □ECBS □ECWC □ECFL □CI □RR □FPT □SN □HT □WP □ Other                                                                                                                                               □P □F □SR  □RC □MFA □WP3 □PPP □PAF □TRC □ITV date □A □R □VL □WL □BL
1	2	3	4	5	6