MINISTRY OF FOREIGN AFFAIRS
PROTOCOL DIVISION
THIMPHU
VISA APPLICATION FORM
(Please fill in block capital letters)


NOTE: If any particulars furnished are found to be incorrect or if information is found to have been withheld, the visa if granted is liable to be cancelled at any time.


THE INFORMATION SUBMITTED MUST BE EXACTLY AS IT APPEARS ON YOUR PASSPORT!!

1. Full Name (exactly as on passport) Mr./Mrs./Ms.________________________________

2. Permanent Address: _______________________________________________________

3. Place of Birth: ________________________ Date of Birth: _______________________

4. Nationality: _________________________________

5. Nature of Passport: Diplomatic/Official/Ordinary/UN Laisser - Passer

6. Passport Number: ____________________Date of Issue: _________________________

    Place of Issue: ______________________ Date of Expiry: ________________________

7. Occupation/Profession: ___________________________________________________

8. Period for which visa is required:__________________

9 Point of entry/exit into Bhutan         Entry:_______________

                                                              Exit:________________

10. Purpose for visiting Bhutan:_______________

11. Is this your first visit to Bhutan? YES/NO. If not, give details of your earlier visit(s):



___________________________________________________________________________



(Please delete whichever is not applicable) 
For Official use only.


Type of Visa: _____________________	Visa Number:_____________________________

Date of Issue: _____________________Visa clearance Number: _____________________




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