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1、U.S.DepartmentofStateSUPPLEMENTALNONIMMIGRANTVISAAPPLICATIONPLEASTTYPEPRINTYOURANSWERSINTHESPACEPROVIDEDBELOWEACHITEMPLEASEATTACHANADDITIONALSHEETIFYOUNEEDMESPACETOCONTINUEYOURANSWERS1.LastName(s)(ListallSpellings)Lu2.Fi
2、rstName(s)(ListallSpellings)Wei3.FullName(inNativeAlphabet)(請?zhí)钪形娜執(zhí)钪形娜?盧巍4.ClanTribeName(IfApplicable)NA5.Spouse’sFullName(IfMarried)NA5.配偶全名配偶全名(如已婚如已婚)無6.Father’sFullNameLuHua6.父親全名父親全名盧華7.Mother’sFullNameWangMei7.母親
3、全名母親全名王梅8.FullNameAddressofContactPersonganizationintheUnitedStates(IncludeTelephoneNumber)SanFranciscoStateUniversityAdd:8BuidlingLusStreetSanFranciscoCA95544USA.TEL:9198760889.ListAllCountriesYouhaveEnteredintheLastTen
4、Years(GivetheYearofEachVisit)USAUKJAPAN10.ListAllCountriesThatHaveEverIssuedYouaPassptChina11.HaveYouEverLostaPassptHadOneStolenYesNo12.NotIncludingCurrentEmployerListYourLastTwoEmployersNameNAAddressTelephoneNo.JobTitle
5、Supervis’sNameDatesofEmployment12.列出上兩任雇主(除現(xiàn)任雇主外)列出上兩任雇主(除現(xiàn)任雇主外)公司名稱:無公司地址:電話號碼:工作職務:主管姓名:起止日期:NameNAAddressTelephoneNo.JobTitleSupervis’sNameDatesofEmployment公司名稱:無公司地址:電話號碼:工作職務:主管姓名:起止日期:13.ListallProfessionalSocialit
6、ableganizationstoWhichYouBelong(Belonged)Contribute(Contributed)withWhichYouWk(HaveWked)…NA14.DoYouHaveAnySpecializedSkillsTrainingIncludingFirearmsExplosivesNuclearBiologicalChemicalExperienceYesNoIfYESpleaseexplain15.H
7、aveYouEverPerfmedMilitaryServiceYesNoIfYesGiveNameofCountryBranchofServiceRankPositionMilitarySpecialtyDatesofService16.HaveYouEverBeeninanArmedConflictEitherasaParticipantVictimYesNoIfYESpleaseexplain.17.ListAllEducatio
8、nalInstitutionsYouAttendHaveAttended.IncludeVocationalInstitutionsButNotElementarySchools.NameofInstitutionJilinInstituteofTechnologyAddressTelephoneNo.ChangchunCity864311111111CourseofStudyBachelofEnglishDatesofAttendan
9、ce9199917.列出所有你曾經(jīng)和目前就讀的學校列出所有你曾經(jīng)和目前就讀的學校包括職校包括職校但不包括小學。但不包括小學。學校名稱:吉林工學院地址電話:中國吉林省長春市人民大街8643111111111所學課程:英語學士起止日期:091999NameofInstitutionBaishanNo.2HighSchoolAddressTelephoneNo.BaishanCity8643932222222CourseofStudySeni
10、highschoolDatesofAttendance091996學校名稱:白山市第二中學地址電話:中國吉林省白山市8643932222222所學課程:高中起止日期:09199618.HaveYouMadeSpecificTravelArrangementsYesNoIfYESpleaseprovideacompleteitineraryfyourtravelincludingarrivaldeparturedatesflightinf
11、mationspecificlocationyouwillvisitapointofcontactateachlocation.PaperwkReductionActStatementPublicreptingburdenfthiscollectionofinfmationisestimatedtoaverage1hourperresponseincludingtimerequiredfsearchingexistingdatasour
12、cesgatheringthenecessarydataprovidingtheinfmationrequiredreviewingthefinalcollection.YoudonothavetoprovidetheinfmationunlessthiscollectiondisplaysacurrentlyvalidOMBnumber.Sendcommentsontheaccuracyofthisestimateoftheburde
13、nrecommendationsfreducingitto:U.S.DepartmentofStateARPSDIRWashingtonDC20520.DS157042006ApprovedOMB14050134Expires09302008EstimatedBurden1hourU.S.DepartmentofStateSUPPLEMENTALNONIMMIGRANTVISAAPPLICATIONPLEASTTYPEPRINTYOUR
14、ANSWERSINTHESPACEPROVIDEDBELOWEACHITEMPLEASEATTACHANADDITIONALSHEETIFYOUNEEDMESPACETOCONTINUEYOURANSWERS1.LastName(s)(ListallSpellings)Lu2.FirstName(s)(ListallSpellings)Wei3.FullName(inNativeAlphabet)(請?zhí)钪形娜執(zhí)钪形娜?盧巍4.Cl
15、anTribeName(IfApplicable)NA5.Spouse’sFullName(IfMarried)NA5.配偶全名配偶全名(如已婚如已婚)無6.Father’sFullNameLuHua6.父親全名父親全名盧華7.Mother’sFullNameWangMei7.母親全名母親全名王梅8.FullNameAddressofContactPersonganizationintheUnitedStates(IncludeTele
16、phoneNumber)SanFranciscoStateUniversityAdd:8BuidlingLusStreetSanFranciscoCA95544USA.TEL:9198760889.ListAllCountriesYouhaveEnteredintheLastTenYears(GivetheYearofEachVisit)USAUKJAPAN10.ListAllCountriesThatHaveEverIssuedYou
17、aPassptChina11.HaveYouEverLostaPassptHadOneStolenYesNo12.NotIncludingCurrentEmployerListYourLastTwoEmployersNameNAAddressTelephoneNo.JobTitleSupervis’sNameDatesofEmployment12.列出上兩任雇主(除現(xiàn)任雇主外)列出上兩任雇主(除現(xiàn)任雇主外)公司名稱:無公司地址:電話號碼
18、:工作職務:主管姓名:起止日期:NameNAAddressTelephoneNo.JobTitleSupervis’sNameDatesofEmployment公司名稱:無公司地址:電話號碼:工作職務:主管姓名:起止日期:13.ListallProfessionalSocialitableganizationstoWhichYouBelong(Belonged)Contribute(Contributed)withWhichYouWk(
19、HaveWked)…NA14.DoYouHaveAnySpecializedSkillsTrainingIncludingFirearmsExplosivesNuclearBiologicalChemicalExperienceYesNoIfYESpleaseexplain15.HaveYouEverPerfmedMilitaryServiceYesNoIfYesGiveNameofCountryBranchofServiceRankP
20、ositionMilitarySpecialtyDatesofService16.HaveYouEverBeeninanArmedConflictEitherasaParticipantVictimYesNoIfYESpleaseexplain.17.ListAllEducationalInstitutionsYouAttendHaveAttended.IncludeVocationalInstitutionsButNotElement
21、arySchools.NameofInstitutionJilinInstituteofTechnologyAddressTelephoneNo.ChangchunCity864311111111CourseofStudyBachelofEnglishDatesofAttendance9199917.列出所有你曾經(jīng)和目前就讀的學校列出所有你曾經(jīng)和目前就讀的學校包括職校包括職校但不包括小學。但不包括小學。學校名稱:吉林工學院地址電話:中國
22、吉林省長春市人民大街8643111111111所學課程:英語學士起止日期:091999NameofInstitutionBaishanNo.2HighSchoolAddressTelephoneNo.BaishanCity8643932222222CourseofStudySenihighschoolDatesofAttendance091996學校名稱:白山市第二中學地址電話:中國吉林省白山市8643932222222所學課程:高中起
23、止日期:09199618.HaveYouMadeSpecificTravelArrangementsYesNoIfYESpleaseprovideacompleteitineraryfyourtravelincludingarrivaldeparturedatesflightinfmationspecificlocationyouwillvisitapointofcontactateachlocation.PaperwkReductio
24、nActStatementPublicreptingburdenfthiscollectionofinfmationisestimatedtoaverage1hourperresponseincludingtimerequiredfsearchingexistingdatasourcesgatheringthenecessarydataprovidingtheinfmationrequiredreviewingthefinalcolle
25、ction.YoudonothavetoprovidetheinfmationunlessthiscollectiondisplaysacurrentlyvalidOMBnumber.Sendcommentsontheaccuracyofthisestimateoftheburdenrecommendationsfreducingitto:U.S.DepartmentofStateARPSDIRWashingtonDC20520.DS1
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