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. 



    


  1. Full name: Mr./Ms./Mrs. _________________________________________________


  2. Permanent address: ______________________________________________________


  3. Place of birth: _____________________ Date of Birth: ____________________


  4. Nationality: ____________________________________________________________


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


  6. Passport number: __________________ Date of Issue: ______________________

    Place of Issue: ___________________ Date of Expiry: _____________________


  7. Occupation / Profession: ________________________________________________


  8. Period for which visa is required: From: _____________ To:_______________


  9. Point of entry/exit into Bhutan: 					 

    
Entry Point: _______________  
Exit Point: ________________  


  10. Purpose for visiting Bhutan: ____________________________________________


  11. 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: _____________