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1、U.S.DepartmentofStateSUPPLEMENTALNONIMMIGRANTVISAAPPLICATIONPLEASTTYPEPRINTYOURANSWERSINTHESPACEPROVIDEDBELOWEACHITEMPLEASEATTACHANADDITIONALSHEETIFYOUNEEDMESPACETOCONTINUEYOURANSWERS1.LastName(s)(ListallSpellings)Lu2.Fi

2、rstName(s)(ListallSpellings)Wei3.FullName(inNativeAlphabet)(請(qǐng)?zhí)钪形娜?qǐng)?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(wú)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(chēng):無(wú)公司地址:電話(huà)號(hào)碼:工作職務(wù):主管姓名:起止日期:NameNAAddressTelephoneNo.JobTitleSupervis’sNameDatesofEmployment公司名稱(chēng):無(wú)公司地址:電話(huà)號(hào)碼:工作職務(wù):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(xué)校列出所有你曾經(jīng)和目前就讀的學(xué)校包括職校包括職校但不包括小學(xué)。但不包括小學(xué)。學(xué)校名稱(chēng):吉林工學(xué)院地址電話(huà):中國(guó)吉林省長(zhǎng)春市人民大街8643111111111所學(xué)課程:英語(yǔ)學(xué)士起止日期:091999NameofInstitutionBaishanNo.2HighSchoolAddressTelephoneNo.BaishanCity8643932222222CourseofStudySeni

10、highschoolDatesofAttendance091996學(xué)校名稱(chēng):白山市第二中學(xué)地址電話(huà):中國(guó)吉林省白山市8643932222222所學(xué)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(qǐng)?zhí)钪形娜?qǐng)?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(wú)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(chēng):無(wú)公司地址:電話(huà)號(hào)碼

18、:工作職務(wù):主管姓名:起止日期:NameNAAddressTelephoneNo.JobTitleSupervis’sNameDatesofEmployment公司名稱(chēng):無(wú)公司地址:電話(huà)號(hào)碼:工作職務(wù):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(xué)校列出所有你曾經(jīng)和目前就讀的學(xué)校包括職校包括職校但不包括小學(xué)。但不包括小學(xué)。學(xué)校名稱(chēng):吉林工學(xué)院地址電話(huà):中國(guó)

22、吉林省長(zhǎng)春市人民大街8643111111111所學(xué)課程:英語(yǔ)學(xué)士起止日期:091999NameofInstitutionBaishanNo.2HighSchoolAddressTelephoneNo.BaishanCity8643932222222CourseofStudySenihighschoolDatesofAttendance091996學(xué)校名稱(chēng):白山市第二中學(xué)地址電話(huà):中國(guó)吉林省白山市8643932222222所學(xué)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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