Form NAI(Under Circular N 04120J5.TT-BCA, 5 Jan. 2015)

1- Full name (in Capital letters): : : .2- Sex: Male 0 Female 03- Date of birth (Day, Month, Year): .4- Place of birth: .5- Nationality at birth: .6- Current nationality: .7- Religion: .8- Occupation: .9- Employer and business address: .

VIETNAMESE VISA APPLICATION FORM (1)(For foreigners)

- Photo 4x6 em

(For looseleaf visa,submit 1 more

photo)See note (2)

10- Permanent residential address: .

TelephonelEmail: .11- Family member(s):

Relationship Full name Sex Date of birth Nationality Permanent residential(See note 3) (in Captialletters) (Day,Month, address

Year)

12- Passport or International Travel Document number: .Type (see note 4) .Issuing authority: Expiry date (Day, moth, year): .! .! .

l3- Date of the previous entry into Viet Nam (if any): .14- Intended date of entry (Day, Month, Year): .! .! .

Intended length of stay in Viet Nam days15- Purpose of entry:16- Intended temporary residential address in Viet Nam:17- Hosting organization/Individual in Viet Nam:

Name of hosting organisation: : .Adress: .

Hosting individual (full name): .Address: .

Relationship to the applicant:

Form NAI(Under Circular N. 0412015.TT-BCA, 5 Jan. 2015)

18- Accompanying child(ren) under 14 years old Photo Photoincluded in your passport (if any) (under 14 (under 14

years old) years old)See note (2) See note (2)

Full name Sex Date of birthNumber (in Capital letters) (Day,Month,Year)

19- Applying for a Visa:Single: Multiple: D Visa sticker: D Loose leaf visa: DValid from (Day, Month, Year): .1 .1 to .1 .1 .

20- Other requests (if any):

I declared to the best of my knowledge that all the above particulars are correct.Done at, date .! .! .

Applicant's signature and full name

Notes:(1) Submit one application form (completed and signed;

Enclosed with passport or International Travel Document, original one (for sticker visa), orcopy of passport (for loose lea/visa);Submit in person or by mail to the Viet Nam Embassy in Oslo at the address below.

(2) Enclose 1 photo (for sticker visa), in 4x6 em size, recently taken with white background, lookahead, bare head, without sunglasses (for loose lea/visa, enclose 1 more photo).

(3) State clearly the in/ormation about parents, spouse, children and siblings (if any).(4) Specify type 0/passport whether it is Ordinary, Official, or Diplomatic or specify name 0/ the

International Travel Document.

Embassy of Viet NamVisiting address: St. Olavs Gate 21 C, 0165 OsloPostal address: P.O.Box 6635 St.Olavs plass, 0130 Oslo.Tel: (+47) 22 2033 00; Fax: (+47) 222033 01Email: vietnamnorway@gmail.com