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 any time.

Full Name: Mr./Ms./Mrs                               :

Permanent Address                                       :

Place of Birth                                                :                                 Date of Birth:

Nationality                                                    :

Nature of  Passport                                       :   Diplomatic/Official/Ordinary/UN Laissez Passer

Passport Number                                          :                                 Date of Issue     :

Place of Issue                                                :                                 Date of Expiry   :

Occupation/Profession                                 :

Period for which Visa is required                :   From:                                       To:

Point of entry/exit into Bhutan:

            Entry Point                                         :
            Exit Point                                           :

Purpose for visiting Bhutan                         :

Is this your first visit to Bhutan ?                  :                                 YES / NO

If NO, give details of earlier visit

Place    :

Date     :                                                                                                     Signature of applicant

                                                                                                          (Attach passport size photograph)

                         ................................................................

 

(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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