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    Cambodia Tourist Visa Form

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    Dunia Film 21
    1) This document is a visa application form for a tourist visa to Cambodia from the Royal Embassy of Cambodia in the United States. 2) It requests basic identification and contact information as well as passport details, vaccination status, intended length and dates of stay in Cambodia, and previous travel history to Cambodia. 3) Upon completion, the applicant declares the information is true and signs the form, which is then processed by the embassy with a possible visa number and remarks noted.

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    © All Rights Reserved
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    Cambodia Tourist Visa Form

    Uploaded by

    Dunia Film 21
    62 views1 page
    1) This document is a visa application form for a tourist visa to Cambodia from the Royal Embassy of Cambodia in the United States. 2) It requests basic identification and contact information as well as passport details, vaccination status, intended length and dates of stay in Cambodia, and previous travel history to Cambodia. 3) Upon completion, the applicant declares the information is true and signs the form, which is then processed by the embassy with a possible visa number and remarks noted.

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    1) This document is a visa application form for a tourist visa to Cambodia from the Royal Embassy of Cambodia in the United States. 2) It requests basic identification and contact information as well as passport details, vaccination status, intended length and dates of stay in Cambodia, and previous travel history to Cambodia. 3) Upon completion, the applicant declares the information is true and signs the form, which is then processed by the embassy with a possible visa number and remarks noted.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    62 views1 page

    Cambodia Tourist Visa Form

    Uploaded by

    Dunia Film 21
    1) This document is a visa application form for a tourist visa to Cambodia from the Royal Embassy of Cambodia in the United States. 2) It requests basic identification and contact information as well as passport details, vaccination status, intended length and dates of stay in Cambodia, and previous travel history to Cambodia. 3) Upon completion, the applicant declares the information is true and signs the form, which is then processed by the embassy with a possible visa number and remarks noted.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    ROYAL EMBASSY OF CAMBODIA KINGDOM OF CAMBODIA

    TO THE UNITED STATES OF AMERICA


    2 x 2 Photo
    4530 16th Street N.W. Nation — Religion — King - only one (1) photo
    Washington D.C. 20011 - taken within six (6) months
    https:/www.embassyofcambodiadc.org - Glue or staple the photo
    both sides (Left & Right)
    VISA APPLICATION FORM - Do not use paper clip

    * Required Tourist (Type-T) Visa


    LAST NAME:* ___________________________________________ Employer: _______________________________________________
    FIRST NAME:*___________________________________________ Current Home Address: ____________________________________
    ________________________________________________________
    GENDER:* MALE FEMALE
    Mobile number:* _________________________________________
    DATE OF BIRTH* DAY______ / MONTH_______ / YEAR_______
    Alternative contact number: ________________________________
    BIRTH NATIONALITY* ____________________________________
    Email address: ___________________________________________
    PRESENT NATIONALITY:*_________________________________
    Port of Entry: (Int’l Airport)* Phnom Penh Siem Reap Sihanoukville
    PLACE OF BIRTH* _______________________________________
    or other Port of Entry: ________________________________________
    PASSPORT NUMBER:*____________________________________
    Address where you will stay in Cambodia? __________________________________
    PLACE OF ISSUE:* _______________________________________ _____________________________________________________________________
    Have you ever been in Cambodia? Yes No If yes, when?_____________
    DATE OF ISSUE:*________________________________________ Have you ever been issued a Cambodian Visa? Yes No
    If Yes, What type of Visa?________________________________________________
    DATE OF EXPIRATION:*___________________________________ Have you ever been refused a Cambodian Visa or been refused admission
    --------------------------------------------------- to Cambodia? Yes No If Yes, What reason? ______________________
    (Approximate date of entry only from A to B) _____________________________________________________________________
    ______________________________________________________________________
    Date A: DAY_______ / MONTH_______ / YEAR__________ ______________________________________________________________________
    Date B: DAY_______ / MONTH_______ / YEAR__________ Your answer will not affect your visa application.
    VACCINATION STATUS?
    LENGTH OF STAY IN CAMBODIA: ___________________________ Are you fully vaccinated? Yes No Vaccine Type? ________________
    --------------------------------------------------- Do you have the vaccination card or certificate? Yes No
    VISA INFORMATION Did you take your booster shot? Yes No
    1. This is valid to use or to enter Cambodia within three(3) months from the date of
    issued and allowed to stay for 30 days upon entering Cambodia.
    2. Visa is renewable for another 30 days at the Cambodia Immigration Office.
    3. It is only a single-entry visa.
    4. It is a sticker visa and needed to affixed to your passport visa page. CAMBODIA ARRIVAL PROCEDURE
    Use your phone camera to scan the QR Code —>>>
    or visit the Embassy website link below.
    https://www.embassyofcambodiadc.org/arrival-procedure.html

    I hereby declare that the information on this form is true and correct to the best of my
    FOR OFFICIAL USE ONLY (052022-1) knowledge.
    **Parent or guardian can sign on behalf of the child (minor).
    DATE PROCESSED:______________________ **Print your complete name and relation.

    VISA NUMBER:_________________________

    REMARKS: _____________________________ ____________________________________________________


    *Print your complete name with signature and date

    TOURIST (VISA-T)

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