GOVERNMENT OF THE UNION OF MYANMAR
IMMIGRATION DEPARTMENT
APPLICATION FOR TOURIST VISA
DEMANDE DE VISA DE TOURISME ------------------------------------------------------------------------------------------------------------------------------------------------------

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01. Full Name (in Block Letters) - ......................................................................................................
        Nom & Prénom en majuscules
02. Sex:                                                               [  ] Female                                          [  ] Male
      Sexe:                                                              Féminin                                               Masculin

03. Nationality - ......................................................................................................................................................
      Nationalité
04. Place & Date of Birth - .....................................................................................................................................
      Lieu & Date de Naissance
05. Marital Status - ..................................................................................................................................................
      Situation de Famille
06. Occupation, Name & Address of Employer - ................................................................................................
      Profession, nom & adresse de l'employeur
      ................................................................................................................................................................................
 
07. Passport No., Date & Place of Issue - ..............................................................................................................
      No Passeport, Date et Lieu d'émission
08. Applicant's Address & Telephone No. (private & professional) - ...............................................................
      Adresse du demandeur et No. de Téléphone (privé & professionnel)
      ...................................................................................................................................................................................

09. Probable duration of stay and Date - ..................................................................................................................
      Durée du séjour prévu et date exacte
10. Date of departure from the country of origin - ...................................................................................................
      Date de départ du pays de résidence
 
 

Place and Date - ......................................................                                         (Signature of Applicant)
Lieu et Date...................                                                                                                                              Signature
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(FOR OFFICE USE ONLY)
Reservé au Consulat  
 
 

Visa No.: ............................................................                                                  For Consul-General
Date       : ............................................................                             Consulate-General of the Union of Myanmar
                                                                                                                                         GENEVA