PhotoStateofIsrael以色列国照片ApplicationforentryvisatoIsrael签证申请表Instructionsforcompletingapplicationform：申请表填写说明:1.PleaseattacharecentIDphotograph.。1.请附一张近期护照照片.2.Ifapplicationisnotforthepurposeofvisit,specifyreasons2.如申请不是为了访问以色列，请详述申请andsupplydocumentation.原因，并递交相关材料.3.PleasefillinfollowingdetailsinHebreworEnglish.3.请用希伯来文或英文填写表格.PreviousfamilynameMother’snameFather’snameGivennameFamilyname曾用名母亲姓名父亲姓名名姓照PreviousnationalityPresentnationalityOccupationDateofbirthPlaceofbirth曾有国籍现国籍职业出生日期出生地点照片□Passport护照□Laissezpasser临时护照Familystatus家庭状况validuntilIssuedonIssuedatNumber□married已婚有效期至签发时间签发地点号码□single未婚□widowed丧偶InEnglish□divorced离异英文IfyouholdaLaissez-PasserissuedbytheStateofyourpermanentPurposeofentryintoIsraelresidence,statewhetheryouhaveareturnvisaandindicateitsvalidity.若进入以色列的目的持永久居留国签发的临时护照，请说明是否具有回程签证及有效期。片permanentaddressabroad中国/他国永久地址telephoneno.Streetandhouseno.Province/CityCountry电话街道及房号省/市国家CountriesoftransitApproximateAnticipateddateandAddressinIsrael中转国durationofstayplaceofentrytoIsrael在以色列地址拟停留期限入境日期及地点CategoryofpreviousresidencepermitinIsrael(visitor,student,DatesofpreviousstaysinIsraeltourist,temporaryresident,resident,immigrant,work)曾在以色列曾在以色列停留日期居留许可类型（访问者、学生签证、旅游签证、临时居民、居民、移民、工作签证）照particularsofdependantsincludedintheapplication申请人随行家属详细情况Spouse配偶Dateofbirthplaceofbirthfather’snamemaidennamegivenname片familyname出生日期出生地点父亲姓名婚前姓名名姓Childrenundertheageof1818岁以下儿童DateofbirthPlaceofbirthGivenname出生日期出生地点姓名.1Relation/referencesinIsrael以色列联系人/亲属Address地址Relationship关系Name姓名.1Declaration声明Ideclarethattheparticularscontainedinthisapplicationarecorrectandhavebeenmadeinawarenessofthefactthattheyaretoserveasbasisfortheconsiderationofmyapplication.IalsodeclarethatIhavenotcommittedanycriminaloffenceoranyactdirectedagainsttheJewishpeopleorthesecurityofthestateofIsraelandthatIamnotaffectedwithanyillnesswhichmightendangerpublichealth.ThereisnojudicialwarrantagainstmeandIamnotwantedbythepoli