ApplicationforSchengenVisaThisapplicationformisfreePHOTO1.Surname(Familyname)(x)FOROFFICIALUSEONLYZhang2.Surnameatbirth(Formerfamilyname(s))(x)Dateofapplication:Visaapplicationnumber:3.Firstname(s)(Givenname(s))(x)SanApplicationlodgedat□Embassy/consulate□CAC4.Dateofbirth(day-month-year)01JAN20005.PlaceofbirthBEIJING6.CountryofbirthCHINA7.CurrentnationalityCHINANationalityatbirth,ifdifferent:□Serviceprovider□Commercialintermediary□BorderName:8.Sex■Male□Female9.Maritalstatus■Single□Married□Separated□Divorced□Widow(er)□Other(pleasespecify)□OtherFilehandledby:Supportingdocuments:10.Inthecaseofminors:Surname,firstname,address(ifdifferentfromapplicant's)and□Traveldocumentnationalityofparentalauthority/legalguardian11.Nationalidentitynumber,whereapplicable11010820000101222212.Typeoftraveldocument■Ordinarypassport□Diplomaticpassport□Servicepassport□Officialpassport□Specialpassport□Othertraveldocument(pleasespecify)□Meansofsubsistence□Invitation□Meansoftransport□TMI□Other:Visadecision:□Refused□Issued:□A□C13.NumberoftraveldocumentG1234567814.Dateofissue15.Validuntil16.IssuedbyExit&EntryAdministrationMinistryofPublicSecurity31DEC202101JAN2012□LTV□Valid:FromUntil17.Applicant'shomeaddressande-mailaddressTelephonenumber(s)13800138000RoomXXX,No.XXX,XXXRoadHaidianDistrict,Beijing,Chinaxxx@xxx.comNumberofentries:□1□2□MultipleNumberofdays:18.Residenceinacountryotherthanthecountryofcurrentnationality■No□Yes.ResidencepermitorequivalentNoValiduntil*19.CurrentoccupationFarmer*20.Employerandemployer'saddressandtelephonenumber.Forstudents,nameandaddressofeducationalestablishment.BeijingXXXXCo.,Ltd.RoomXXX,No.XXX,XXXRoad,HaidianDistrict,Beijing,China010-8888888821.Mainpurpose(s)ofthejourney:■Tourism□Business□Visitingfamilyorfriends□Cultural□Sports□Officialvisit□Medicalreasons□Study□Transit□Airporttransit□Other(pleasespecify)22.MemberState(s)ofdestinationBelgiu