1. Passport Number护照号码

2. Place of Issuance发照地点:

DO NOT WRITE IN THIS SPACE

请勿填写此处

3. Issuing Country发照国家
SelectAFGHANISTANALBANIAALGERIAANDORRAANGOLAANGUILLAANTIGUA AND BARBUDAARGENTINAARMENIAARUBAAUSTRALIAAUSTRIAAZERBAIJANBAHRAINBANGLADESHBARBADOSBELARUSBELGIUMBELIZEBENINBERMUDABHUTANBOLIVIABOSNIA-HERZEGOVINABOTSWANABRAZILBRITISH INDIAN OCEAN TERRITORYBRITISH VIRGIN ISLANDSBRUNEIBULGARIABURKINA FASOBURMABURUNDICAMBODIACAMEROONCANADACAPE VERDECAYMAN ISLANDSCENTRAL AFRICAN REPUBLICCHADCHILECHINA - MAINLANDCOLOMBIACOMOROSCONGO (BRAZZAVILLE)CONGO (KINSHASA)COSTA RICACOTE D`IVOIRECROATIACUBACYPRUSCZECH REPUBLICDENMARKDJIBOUTIDOMINICADOMINICAN REPUBLICEAST TIMORECUADOREGYPTEL SALVADOREQUATORIAL GUINEAERITREAESTONIAETHIOPIAFEDERATED STATES OF MICRONESIAFIJIFINLANDFRANCEGABONGEORGIAGERMANYGHANAGIBRALTARGREAT BRITAIN AND NORTHERN IRELANDGREECEGRENADAGUATEMALAGUINEAGUINEA - BISSAUGUYANAHAITIHONDURASHONG KONGHONG KONG S. A. R.HUNGARYICELANDINDIAINDONESIAIRANIRAQIRELANDISRAELITALYJAMAICAJAPANJORDANKAZAKHSTANKENYAKIRIBATIKUWAITKYRGYZSTANLAOSLATVIALEBANONLESOTHOLIBERIALIBYALIECHTENSTEINLITHUANIALUXEMBOURGMACAUMADAGASCARMALAWIMALAYSIAMALDIVESMALIMALTAMAURITANIAMAURITIUSMEXICOMOLDOVAMONACOMONGOLIAMONTSERRATMOROCCOMOZAMBIQUENAMIBIANAURUNEPALNETHERLANDSNETHERLANDS ANTILLESNEW CALEDONIANEW ZEALANDNICARAGUANIGERNIGERIANORWAYOMANPAKISTANPALESTINIAN AUTHORITYPANAMAPAPUA NEW GUINEAPARAGUAYPEOPLES REPUBLIC OF KOREA - NORTH KOREAPERUPHILIPPINESPITCAIRN ISLANDSPOLANDPORTUGALQATARREPUBLIC OF KOREA (SOUTH KOREA)REPUBLIC OF MACEDONIAREPUBLIC OF PALAUREPUBLIC OF THE MARSHALL ISLANDSROMANIARUSSIARWANDASAMOASAN MARINOSAO TOME AND PRINCIPESAUDI ARABIASENEGALSERBIA AND MONTENEGROSEYCHELLESSIERRA LEONESINGAPORESLOVAKIASLOVENIASOLOMON ISLANDSSOMALIASOUTH AFRICASPAINSRI LANKAST. HELENAST. KITTS AND NEVISST. LUCIAST. VINCENT AND THE GRENADINESSUDANSURINAMESWAZILANDSWEDENSWITZERLANDSYRIATAIWANTAJIKISTANTANZANIATHAILANDTHE BAHAMASTHE GAMBIATOGOTONGATRINIDAD AND TOBAGOTUNISIATURKEYTURKMENISTANTURKS AND CAICOS ISLANDSTUVALUUGANDAUKRAINEUNITED ARAB EMIRATESUNITED NATIONS LAISSEZ-PASSERURUGUAYUZBEKISTANVANUATUVATICAN CITYVENEZUELAVIETNAMWALLIS AND FUTUNA ISLANDSWESTERN SAHARAYEMENZAMBIAZIMBABWE

4. Issuance Date (dd-month-yyyy)

    发照日期 (日-月-年)

5. Expiration Date (dd-month-yyyy)

    失效日期(日-月-年)

6. Surnames (As in Passport) 姓(与护照上一致)

7. First and Middle Names (As in Passport) 名(与护照上一致)

8. Other Surnames Used (Maiden, Religious, Professional, Aliases) 其他曾用姓氏（未婚时称呼、宗教称呼、工作用称呼、化名）

9. Other First and Middle Names Used其他曾用名字

10. Date of Birth (dd-month-yyyy)

     出生日期(日-月-年)

11. Place of Birth 出生地点

12. Nationality国籍
SelectAFGHANISTANALBANIAALGERIAANDORRAANGOLAANGUILLAANTIGUA AND BARBUDAARGENTINAARMENIAARUBAAUSTRALIAAUSTRIAAZERBAIJANBAHRAINBANGLADESHBARBADOSBELARUSBELGIUMBELIZEBENINBERMUDABHUTANBOLIVIABOSNIA-HERZEGOVINABOTSWANABRAZILBRITISH INDIAN OCEAN TERRITORYBRITISH VIRGIN ISLANDSBRUNEIBULGARIABURKINA FASOBURMABURUNDICAMBODIACAMEROONCANADACAPE VERDECAYMAN ISLANDSCENTRAL AFRICAN REPUBLICCHADCHILECHINA - MAINLANDCOLOMBIACOMOROSCONGO (BRAZZAVILLE)CONGO (KINSHASA)COSTA RICACOTE D`IVOIRECROATIACUBACYPRUSCZECH REPUBLICDENMARKDJIBOUTIDOMINICADOMINICAN REPUBLICEAST TIMORECUADOREGYPTEL SALVADOREQUATORIAL GUINEAERITREAESTONIAETHIOPIAFEDERATED STATES OF MICRONESIAFIJIFINLANDFRANCEGABONGEORGIAGERMANYGHANAGIBRALTARGREAT BRITAIN AND NORTHERN IRELANDGREECEGRENADAGUATEMALAGUINEAGUINEA - BISSAUGUYANAHAITIHONDURASHONG KONGHONG KONG S. A. R.HUNGARYICELANDINDIAINDONESIAIRANIRAQIRELANDISRAELITALYJAMAICAJAPANJORDANKAZAKHSTANKENYAKIRIBATIKUWAITKYRGYZSTANLAOSLATVIALEBANONLESOTHOLIBERIALIBYALIECHTENSTEINLITHUANIALUXEMBOURGMACAUMADAGASCARMALAWIMALAYSIAMALDIVESMALIMALTAMAURITANIAMAURITIUSMEXICOMOLDOVAMONACOMONGOLIAMONTSERRATMOROCCOMOZAMBIQUENAMIBIANAURUNEPALNETHERLANDSNETHERLANDS ANTILLESNEW CALEDONIANEW ZEALANDNICARAGUANIGERNIGERIANORWAYOMANPAKISTANPALESTINIAN AUTHORITYPANAMAPAPUA NEW GUINEAPARAGUAYPEOPLES REPUBLIC OF KOREA - NORTH KOREAPERUPHILIPPINESPITCAIRN ISLANDSPOLANDPORTUGALQATARREPUBLIC OF KOREA (SOUTH KOREA)REPUBLIC OF MACEDONIAREPUBLIC OF PALAUREPUBLIC OF THE MARSHALL ISLANDSROMANIARUSSIARWANDASAMOASAN MARINOSAO TOME AND PRINCIPESAUDI ARABIASENEGALSERBIA AND MONTENEGROSEYCHELLESSIERRA LEONESINGAPORESLOVAKIASLOVENIASOLOMON ISLANDSSOMALIASOUTH AFRICASPAINSRI LANKAST. HELENAST. KITTS AND NEVISST. LUCIAST. VINCENT AND THE GRENADINESSUDANSURINAMESWAZILANDSWEDENSWITZERLANDSYRIATAIWANTAJIKISTANTANZANIATHAILANDTHE BAHAMASTHE GAMBIATOGOTONGATRINIDAD AND TOBAGOTUNISIATURKEYTURKMENISTANTURKS AND CAICOS ISLANDSTUVALUUGANDAUKRAINEUNITED ARAB EMIRATESUNITED NATIONS LAISSEZ-PASSERURUGUAYUZBEKISTANVANUATUVATICAN CITYVENEZUELAVIETNAMWALLIS AND FUTUNA ISLANDSWESTERN SAHARAYEMENZAMBIAZIMBABWE

13. Sex 性别

14. National Identification Number 身份证号码
(If applicable)(如适用)

15. Home Address (Include apartment number, street, city, state or province, postal zone and country)

     住址（国家、邮递区号、州／省、城市、街道、单元号码）
Street Address Line 1 街道名称(第一行)

Street Address Line 2 街道名称(第二行)

City城市

State/Province州/省

Postal Code 邮政编码

Country 国家
SelectAFGHANISTANALBANIAALGERIAAMERICAN SAMOAANDORRAANGOLAANGUILLAANTIGUA AND BARBUDAARGENTINAARMENIAARUBAAUSTRALIAAUSTRIAAZERBAIJANBAHRAINBAKER ISLANDBANGLADESHBARBADOSBELARUSBELGIUMBELIZEBENINBERMUDABESSARABIABHUTANBOLIVIABOSNIA-HERZEGOVINABOTSWANABRAZILBRITISH INDIAN OCEAN TERRITORYBRITISH VIRGIN ISLANDSBRUNEIBULGARIABURKINA FASOBURMABURUNDICAMBODIACAMEROONCANADACAPE VERDECAYMAN ISLANDSCENTRAL AFRICAN REPUBLICCHADCHILECHINA - MAINLANDCHRISTMAS ISLANDCOCOS KEELING ISLANDSCOLOMBIACOMOROSCONGO (BRAZZAVILLE)CONGO (KINSHASA)COOK ISLANDSCOSTA RICACOTE D`IVOIRECROATIACUBACYPRUSCZECH REPUBLICDANZIGDENMARKDJIBOUTIDOMINICADOMINICAN REPUBLICEAST PRUSSIAEAST TIMORECUADOREGYPTEL SALVADOREQUATORIAL GUINEAERITREAESTONIAETHIOPIAFALKLAND ISLANDSFAROE ISLANDSFEDERATED STATES OF MICRONESIAFIJIFINLANDFRANCEFRENCH GUIANAFRENCH POLYNESIAFRENCH SOUTHERN & ANTARCTIC TERRITORIESGABONGAZA STRIPGDANSKGEORGIAGERMANYGHANAGIBRALTARGREAT BRITAIN AND NORTHERN IRELANDGREECEGREENLANDGRENADAGUADELOUPEGUAMGUATEMALAGUINEAGUINEA - BISSAUGUYANAHAITIHEARD AND MCDONALD ISLANDSHONDURASHONG KONGHONG KONG S. A. R.HOWLAND ISLANDHUNGARYICELANDINDIAINDONESIAIRANIRAQIRELANDISRAELITALYJAMAICAJAPANJOHNSTON ATOLLJORDANKAZAKHSTANKENYAKIRIBATIKUWAITKYRGYZSTANLAOSLATVIALEBANONLESOTHOLIBERIALIBYALIECHTENSTEINLITHUANIALUXEMBOURGMACAUMADAGASCARMALAWIMALAYSIAMALDEN ISLANDMALDIVESMALIMALTAMARTINIQUEMAURITANIAMAURITIUSMAYOTTEMEXICOMIDWAY ISLANDSMOLDOVAMONACOMONGOLIAMONTSERRATMOROCCOMOZAMBIQUENAMIBIANAURUNEPALNETHERLANDSNETHERLANDS ANTILLESNEW CALEDONIANEW ZEALANDNICARAGUANIGERNIGERIANIUENO MARIANA ISLANDS (USA)NORTHERN IRELANDNORWAYOMANPAKISTANPALESTINIAN AUTHORITYPALMYRA ATOLLPANAMAPAPUA NEW GUINEAPARAGUAYPEOPLES REPUBLIC OF KOREA - NORTH KOREAPERUPHILIPPINESPITCAIRN ISLANDSPOLANDPORTUGALPUERTO RICOQATARREPUBLIC OF KOREA (SOUTH KOREA)REPUBLIC OF MACEDONIAREPUBLIC OF PALAUREPUBLIC OF THE MARSHALL ISLANDSREUNIONROMANIARUSSIARWANDASAMOASAN MARINOSAO TOME AND PRINCIPESAUDI ARABIASENEGALSERBIA AND MONTENEGROSEYCHELLESSIERRA LEONESINGAPORESLOVAKIASLOVENIASOLOMON ISLANDSSOMALIASOUTH AFRICASPAINSRI LANKAST MARTINST. HELENAST. KITTS AND NEVISST. LUCIAST. PIERRE & MIQUELONST. VINCENT AND THE GRENADINESSUDANSURINAMESWAZILANDSWEDENSWITZERLANDSYRIATAIWANTAJIKISTANTANZANIATHAILANDTHE BAHAMASTHE GAMBIATOGOTOKELAUTONGATRINIDAD AND TOBAGOTUNISIATURKEYTURKMENISTANTURKS AND CAICOS ISLANDSTUVALUUGANDAUKRAINEUNITED ARAB EMIRATESUNITED NATIONS LAISSEZ-PASSERUNITED STATES OF AMERICAURUGUAYUZBEKISTANVANUATUVATICAN CITYVENEZUELAVIETNAMVIRGIN ISLANDS (U.S.)WAKE ISLANDWALLIS AND FUTUNA ISLANDSWEST BANKWESTERN SAHARAYEMENZAMBIAZIMBABWE

17. Marital Status婚姻状况
Married已婚 Single (Never Married) 单身(未婚)
Widowed丧偶 Divorced离婚 Separated分居

18. Spouse's Full Name配偶全名
(Even if divorced or separated. Include maiden name.)

(不论离婚或分居，包括婚前姓名)

19. Spouse's DOB (dd-month-yyyy)

     配偶出生日期(日-月-年)

20. Name and Address of Present Employer or School 现任工作单位或就读学校名称、地址

21. Present Occupation现任职业
(If retired, write "retired". If student, write "student".)

(如退休, 则填写"retired". 如是学生,则填写"student".)

22. When Do You Intend To Arrive In The U.S.? 拟抵美时间
(Provide specific date if known) (如有确定日期,请提供)

23. E-Mail Address 电子邮件地址

24. At What Address Will You Stay in The U.S.?在美期间住址
Street Address Line 1 街道名称(第一行)

Street Address Line 2 街道名称(第二行)

City城市

State/Province州/省

Postal Code邮政编码

25. Name and Telephone Numbers of Person in U.S. Who You Will Be Staying With or Visiting for Tourism or Business

     您将在美国与其居住或因旅游或公务原因将探访之联络人的姓名及电话号码

DO NOT WRITE IN THIS SPACE

请勿填写此处

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50毫米X 50毫米
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Glue photo here.

请用胶水将照片粘贴于此处。
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26. How Long Do You Intend To Stay in The U.S.? 预计在美停留多久?

27. What is The Purpose of Your Trip?此行目的

28. Who Will Pay For Your Trip?此行费用由谁负担?

29. Have You Ever Been in The U.S.?您是否到过美国? Yes是 No否

FOR HOW LONG? 逗留了多久?

Enter Additional Visits to the U.S. Here: 请在此填写其它访美及停留时间:

30. Have You Ever Been Issued a U.S. Visa? 您是否曾得到过美国签证 Yes 是 No否

WHERE? 在何地?
WHAT TYPE OF VISA? 哪类签证?SelectA1 - AMBASSADOR, DIPLOMAT OR CONOFF AND IMMED FAMILYA2 - OTHER FOREIGN GOVT OFFICIAL AND IMMEDIATE FAMILYA3 - PERSONAL EMPLOYEE OF A1/ A2 AND IMMEDIATE FAMILYB1 - VISITOR FOR BUSINESSB1/B2 - VISITOR FOR BUSINESS AND PLEASUREB2 - VISITOR FOR PLEASUREBBBCC - B-1/ B-2/ BCC COMBINATION VISA MEXC1 - ALIEN IN TRANSITC1/D - ALIEN CREWMEMBER IN TRANSITC2 - ALIEN IN TRANSIT - UNITED NATIONSC3 - TRANSIT - FOREIGN OFFICIAL/FAMILYD - CREW MEMBER ( SHIP OR AIRCRAFT CREW)E1 - TREATY TRADER, SPOUSE, CHILDRENE2 - TREATY INVESTOR, SPOUSE, CHILDRENF1 - STUDENT (ACADEMIC OR LANGUAGE)F2 - SPOUSE/ CHILD OF F-1F3 - BORDER COMMUTER STUDENTG1 - PERM REPRESENTATIVE TO INTL ORG AND IMMED FAMILYG2 - TEMP REPRESENTATIVE TO INTL ORG AND IMMED FAMILYG3 - REP NONREC/MEMBER GOVT TO INTL ORG & IMMED FAMILYG4 - EMPLOYEE OF INTL ORG AND IMMEDIATE FAMILYG5 - PERSONAL EMPLOYEE OF G-1/2/3/4 & IMMEDIATE FAMILYH1B - TEMP WKER DISTINGUISHED MERIT ( OTHER THAN NURSE)H1B1 - FREE TRADE AGREEMENT NONIMMIGRANT PROFESSIONALSH1C - SHORTAGE AREA NURSEH2A - TEMPORARY AGRICULTURAL WORKERH2B - NON-AGRICULTURAL TEMPORARY WORKERH3 - TRAINEEH4 - SPOUSE/ CHILD OF H1 B/1 C/2 A/2 B/3I - FOREIGN INFO MEDIA AND SPOUSE AND CHILDRENJ1 - EXCHANGE VISITORJ2 - SPOUSE/ CHILD OF J-1K1 - FIANCE OR FIANCEE OF U. S. CITIZENK2 - CHILD OF K-1K3 - SPOUSE OF U S CITIZENK4 - CHILD OF K-3L1 - INTRA-COMPANY TRANSFEREE(EXEC, MGR)L2 - SPOUSE/ CHILD OF L-1M1 - VOCATIONAL/TECHNICAL STUDENTM2 - SPOUSE/ CHILD OF M-1M3 - BORDER COMMUTER VOCATIONAL STUDENTN8 - PARENT OF SK3 INTL ORGANIZATION SPECIAL IMMIGRANTN9 - CHILD OF N-8 OR OF SK1, SK2 OR SK4 SPEC IMMIGRANTNATO1 - NATO1NATO2 - NATO2NATO3 - NATO3NATO4 - NATO4NATO5 - NATO5NATO6 - NATO6NATO7 - PERSONAL EMPLOYEE OF NATO-1/6O1 - ALIEN OF EXTRAORDINARY ABILITYO2 - ALIEN ACCOMPANYING O-1 ALIENO3 - SPOUSE/ CHILD OF O-1 OR O-2 ALIENP1 - ATHLETE OR ENTERTAINMENT GROUP - SPECIFIC EVENTP2 - ARTIST - RECIPROCAL EXCHANGEP3 - CULTURALLY UNIQUE ARTISTP4 - SPOUSE/ CHILD OF P-1, P-2, OR P-3Q1 - INTERNATIONAL CULTURAL EXCHANGEQ2 - IRISH PEACE PROCESS TRAINEE( DUBLIN/ BELFAST ONLY)Q3 - SPOUSE/ CHILD OF Q-2 ( DUBLIN/ BELFAST ONLY)R1 - ALIEN IN RELIGIOUS OCCUPATIONR2 - SPOUSE/ CHILD OF R-1 ALIENS5 - ALIEN PROVIDING CRIMINAL INFORMATIONS6 - ALIEN PROVIDING TERRORISM INFORMATIONS7 - SPOUSE/ SON/DAUGHTER OR PARENT OF S-5 OR S-6T2 - SPOUSE OF T1T3 - CHILD OF T1T4 - PARENT OF T1 CHILDTD - N A F T A DERIVATIVE ( SPOUSE/ CHILD OF TN)TN - N A F T A PROFESSIONALV1 - SPOUSE OF L P R - L I F E ACT VISAV2 - CHILD OF L P R - CHILD PRINCIPA L - LIFE ACTV3 - DERIVATIVE CHILD OF V1 OR V2
Enter Additional Visa Issuances Here: 请在此填写其它获签记录:

31. Have You Ever Been Refused a U.S. Visa? 您是否曾被拒签过美国签证? Yes是 No否

WHERE?在何地?
WHAT TYPE OF VISA? 哪类签证?

SelectA1 - AMBASSADOR, DIPLOMAT OR CONOFF AND IMMED FAMILYA2 - OTHER FOREIGN GOVT OFFICIAL AND IMMEDIATE FAMILYA3 - PERSONAL EMPLOYEE OF A1/ A2 AND IMMEDIATE FAMILYB1 - VISITOR FOR BUSINESSB1/B2 - VISITOR FOR BUSINESS AND PLEASUREB2 - VISITOR FOR PLEASUREBBBCC - B-1/ B-2/ BCC COMBINATION VISA MEXC1 - ALIEN IN TRANSITC1/D - ALIEN CREWMEMBER IN TRANSITC2 - ALIEN IN TRANSIT - UNITED NATIONSC3 - TRANSIT - FOREIGN OFFICIAL/FAMILYD - CREW MEMBER ( SHIP OR AIRCRAFT CREW)E1 - TREATY TRADER, SPOUSE, CHILDRENE2 - TREATY INVESTOR, SPOUSE, CHILDRENF1 - STUDENT (ACADEMIC OR LANGUAGE)F2 - SPOUSE/ CHILD OF F-1F3 - BORDER COMMUTER STUDENTG1 - PERM REPRESENTATIVE TO INTL ORG AND IMMED FAMILYG2 - TEMP REPRESENTATIVE TO INTL ORG AND IMMED FAMILYG3 - REP NONREC/MEMBER GOVT TO INTL ORG & IMMED FAMILYG4 - EMPLOYEE OF INTL ORG AND IMMEDIATE FAMILYG5 - PERSONAL EMPLOYEE OF G-1/2/3/4 & IMMEDIATE FAMILYH1B - TEMP WKER DISTINGUISHED MERIT ( OTHER THAN NURSE)H1B1 - FREE TRADE AGREEMENT NONIMMIGRANT PROFESSIONALSH1C - SHORTAGE AREA NURSEH2A - TEMPORARY AGRICULTURAL WORKERH2B - NON-AGRICULTURAL TEMPORARY WORKERH3 - TRAINEEH4 - SPOUSE/ CHILD OF H1 B/1 C/2 A/2 B/3I - FOREIGN INFO MEDIA AND SPOUSE AND CHILDRENJ1 - EXCHANGE VISITORJ2 - SPOUSE/ CHILD OF J-1K1 - FIANCE OR FIANCEE OF U. S. CITIZENK2 - CHILD OF K-1K3 - SPOUSE OF U S CITIZENK4 - CHILD OF K-3L1 - INTRA-COMPANY TRANSFEREE(EXEC, MGR)L2 - SPOUSE/ CHILD OF L-1M1 - VOCATIONAL/TECHNICAL STUDENTM2 - SPOUSE/ CHILD OF M-1M3 - BORDER COMMUTER VOCATIONAL STUDENTN8 - PARENT OF SK3 INTL ORGANIZATION SPECIAL IMMIGRANTN9 - CHILD OF N-8 OR OF SK1, SK2 OR SK4 SPEC IMMIGRANTNATO1 - NATO1NATO2 - NATO2NATO3 - NATO3NATO4 - NATO4NATO5 - NATO5NATO6 - NATO6NATO7 - PERSONAL EMPLOYEE OF NATO-1/6O1 - ALIEN OF EXTRAORDINARY ABILITYO2 - ALIEN ACCOMPANYING O-1 ALIENO3 - SPOUSE/ CHILD OF O-1 OR O-2 ALIENP1 - ATHLETE OR ENTERTAINMENT GROUP - SPECIFIC EVENTP2 - ARTIST - RECIPROCAL EXCHANGEP3 - CULTURALLY UNIQUE ARTISTP4 - SPOUSE/ CHILD OF P-1, P-2, OR P-3Q1 - INTERNATIONAL CULTURAL EXCHANGEQ2 - IRISH PEACE PROCESS TRAINEE( DUBLIN/ BELFAST ONLY)Q3 - SPOUSE/ CHILD OF Q-2 ( DUBLIN/ BELFAST ONLY)R1 - ALIEN IN RELIGIOUS OCCUPATIONR2 - SPOUSE/ CHILD OF R-1 ALIENS5 - ALIEN PROVIDING CRIMINAL INFORMATIONS6 - ALIEN PROVIDING TERRORISM INFORMATIONS7 - SPOUSE/ SON/DAUGHTER OR PARENT OF S-5 OR S-6T2 - SPOUSE OF T1T3 - CHILD OF T1T4 - PARENT OF T1 CHILDTD - N A F T A DERIVATIVE ( SPOUSE/ CHILD OF TN)TN - N A F T A PROFESSIONALV1 - SPOUSE OF L P R - L I F E ACT VISAV2 - CHILD OF L P R - CHILD PRINCIPA L - LIFE ACTV3 - DERIVATIVE CHILD OF V1 OR V2
Enter Additional Visa Refusals Here: 请在此填写其它拒签记录:

32. Do You Intend To Work in The U.S.? 您是否有意在美国就业? Yes是 No否
(If YES, give the name and complete address of U.S. employer.)

(如有意就业，请提供美国雇主的名称及地址。)

33. Do You Intend To Study in The U.S.? 您是否有意在美国就读? Yes是 No否
(If YES, give the name and complete address of the school.)

(如有意就读,请提供美国学校的名称和地址。)

34. Names and Relationships of Persons Traveling With You同行人姓名及与您的关系

35. Has Your U.S. Visa Ever Been Cancelled or Revoked? 您的美国签证是否曾被吊销或作废？

  Yes是 No否

36. Has Anyone Ever Filed an Immigrant Visa Petition on Your Behalf? 是否曾有人为您申办过移民签证？
Yes有 No没有   If Yes, Who? 如有，是谁？

37. Are Any of The Following Persons in The U.S., or Do They Have U.S. Legal Permanent Residence or U.S. Citizenship? 下列亲属中是否有人目前已在美国？他们是否是美国合法永久居民或美国公民？
Mark YES or NO and indicate that person's status in the U.S. (i.e., U.S. legal permanent resident, U.S. citizen, visiting, studying, working, etc.)

请注明“在美国”、“不在美国”，并注明其在美国的身份（即：是美国合法永久居民还是美国公民，是否正在美国访问、留学、工作等）