Visa Application Form
PROTOCOL DIVISION
THIMPHU
VISA APPLICATION FORM
(Please fill in block capital letters)
(Note: If any particulars furnished below are found to be incorrect or if any information is found to have been withheld, the visa, if granted, is liable to be cancelled at any time)
1. Full name: Mr./Ms. __________________________________________________________
2. Permanent address
__________________________________________________________
__________________________________________________________
__________________________________________________________
3. Place of birth: __________________ Date of birth: __________________
4. Nationality: __________________________________________________________
5. Nature of passport: *Diplomatic / Official / Ordinary / UN Laissez-Passer
6. Passport number:__________________ Date of issue: __________________
Place of issue: __________________ Date of expiry: __________________
7. Occupation/Profession: __________________________________________________________
8. Period for which visa is required: From: ______________ to: _______________
9. Point of entry/exit into Bhutan: Entry Point :______________ Exit Point: ______________
10. Purpose for visiting Bhutan: __________________________________________________________
11. Is this your first visit to Bhutan? *Yes / No. If not, give details of earlier visit
Place: __________________________________________________________
Date: __________________________________________________________
Signature of applicant: __________________________________________________________
(*Please delete whichever is not applicable)
For official use only:
Type of visa ______________
Visa number ______________ (Attach passport
Date of issue ______________ size photograph)
Visa clearance number ______________
Back to the Celebrating Mountain Women home page
