China Visa Checklist for US Citizens

USC Students/US

1. Passport

2. Passport-style photo (2x2)

3. Visa application (download it to your computer, type in your answers, save and print the form)

4. Copy of USC student I.D.

5. Copy of drivers license or state I.D.

6. Arista order form

VISA FEE PAYMENT

By Check: $140.00. (Make  your  check  payable  to  “Arista  Passport  &  Visa  Services  Inc.”)

Or…

By Credit Card: $145.00. (Fill out your credit card info on the Arista order form.)

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~~A~~~OO~YE$1#~ f/isa Application FUI'm of tile People's Republic of Cllina

(For the Mabdand of China only)

titA..~·~l-*"~. st4. 7tjiJt!AIP~U4 . itltlJi~~ro ;t:Jf-l 'I'~A,l:~:k.~~.BJ:.ff!!p~~. A.{£o I*J-tr'i'i&#--. -*"* *.l/i SJ ;f:i!Jf-l , ~~ " fG ' . The applicant should nn in tbis form truthfully , completely and clearly. Please type the answer in capital English

letters In the space provided or tick ('I') the relevant box to select. H some of the Items do not apply, please type N I A or None.

-, -1'-A ffi ,lffi, Part 1: Personal Information

~Last name

1.1~)(~~ t~!IJi-tijgj.iEifi!Mif, ~~-Jf Full English name 9='raJ~ Middle name

as In passport ·ll<J~~!Pil«JIIlJt.

lftUt!Photo ~ Firstname Aflb: one rec:ent c:ollll' passport

1.2 9=')(~~ 1.3 ~J~!ltf.t ffl~ photo (full fac:e, front view, bareheaded and against a plain

Name In Chinese Other name(s) light colored ba~oond).

1.4 ·~~j Sex D!JJM D ""!;: F 1.s I±!~BM DOB(yyyy-mm-dd)

1.6 JJII.:ff~- 1.7 if:ffi'!UI Former nationallty(ies) Current nationality(ies)

1.81±\~:ti!L~(rtr, ~/ftl, ~) Place of birth( city, province/state,country)

1.9 ~·6HiEt0~iiE~lij Local ID/ Citizenship number

1.10 ~ Iff( tth. :ff iiE {lj: # ~ Passportffravel document D *3t Diplomatic D 0~, '§' ~ Sen1c:e or Official

type D -ft:li Ordinary D ;ltftki!E1tf(1filt~) Other (Please specify):

1.11 ~Jm~{il! 1.12~1t B:M Passport number Date of lssue(yyyy-mm-dd)

1.13~1t~~ 1.14~~B:M Place of issue Date of e:r.piry(yyyy-mm-dd)

D mi'A Businessperson D fJJ/JJ/I.tEiSCm Former/incumbent member of parliament

D *iil liRJn Company employee J{R{i[ Position

D ~~AJn Entertainer D fJJ/JJ/I.tE:®:Jf.f'§' Jji Former/incumbent government

D IN :ft.~ Industrial/Agrkultural worker official

liR{iL Position

1.15 ~litrliR~ D ~~Student D~A Military personnel

( PJ~$:g)i) D ~~ A9i Crew member liR {iL Position Current D 13 )li! Self-employed oa:upation( s) D ~1=-iltJf.fmAAAJn NGO staff

D X~ Unemployed D *~A± ReUgious personnel

D lll-Pf\ Retired D ifllilhJ..~A~ Statfofmedla

D ;ltfm(lfilt~) Other (Please •eclfy):

1.16 ~~lfM D ~~~ Postgraduate D -};:.~College

Education D ;ltfm(l#iSt~) Other (Please •eclfy):

~:f$ ll*ffilt!i! 1.17 I f!=.l)l{iLJ~;fSt Name Phone number

Employer/School llr~ilttJ!ilfi!3 ~bi: Address Zip Code

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1.18 ~BlH±fJI: 1.19 ~~lll~.fj.q Home address Zip Code

1.20 11!1%/~:m 1.2111!-T~~m Home/mobile phone number E-mail address

1.22 tfi1ii~Pt~m. Marital status D Bf@ Married D lfi.~ Single D Jtftk Other(Please specify):

!e:~ Name 00 Mf Nationality JIR~ Occupation ~~ Relationship 1.23 .:E~~J!n!GLQ (fta~, r~- :5t-BJ. ~.iiJ~~) MI\Jor family members (spouse, chlldren,parents,et c.,may type on separate paper)

1.24 te:~ ¥-m jt~lfR~.A.ffi.m Name Mobile phone number Emergency ~~iiAB<J~~ Contact Relationship with the appUcant

1.25 *~.A. ~~:'£i!E lit nf{E (!(} j;i!l ~!!Jt:tikl8: Country or territory where the applicant is located when applying for this visa

:bttrm .~ Part 2: Travel Information

D '$'1J1/i fR] Official VIsit o 'I!UH~~' @i$, P!l~m~A.M

D /h..W/ Tourism As resident diplomat, consul or staff of international organization

D 3t:v!t, ~-. 1/ifRJ Non-businessvim D i.k?-..Mii As permanent resident

D ill.ikM J1r Business & Trade D I fF Work

D A;t~l:itt As Introduced talent D -~ As child in foster care

D t4.:fr~* As crew member

D )i;lj Transit

2.1 *iW D mWH*~tf!~~~~iilt~A:fl9='1Ei.kAMiiJ£~a<J D ~9=' 00 ~~lilt~ A:fltf' OOi.kAMiiJf~a<J;r lEA

,A:Ijt~JEI:i MI\Jor * j;i!l A Short-term visit to Chinese cltlzen or ~I! 00 ~Mit S r1: 180 13 Family reunion for over

purpose foreigner with Chinese permanent residence datus 180 days with Chinese cltlzen or foreigner with

of your visit Chinese permanent residence status D ~H!Il~~~If'F, ?F;J~$EI=rtE9='00WIWMIWa<J o *»~i~t~~I fF,?F;a~$mtE9=' oomii a<J9rOOA *lEA Short-term visit to foreigner residing in As accompanying family member of foreigner China due to work, study or other reasons residing In China due to work, study or other reasons

D mM?F;J Short-term study for less than 180 days D *»>?F;J Long-term study for over 180 days

0 m»J*1/imli AsjournaUst for temporary oews D9r Pi! 'lit llt 9=' 00 jj-pg :mtJ;Jm~ As resident Journalist coverage

D Jtftk(ijJill,I@)Other (Please specify):

D -tX( § ~~2.13 ® 31-~ :fl~) One entry vaUd for 3 months from the date of issue

2.2 -H-i!! D .::::.tX(§~~Z.I3® ~61-~:fl~) Twoentrlesvalldfor 3to6 months from the date of Issue .A:IjttXIV: D :$-~~tX ( § ~~Z. 13 ® 61-~ :fl~) Multiple entries vaUd for 6 months from the date of Issue Intended number of entries D -~~tX ( §~~2.13® 1 ~:fl~O MultlpleentrlesvaUdfor 1 year from the date of Issue

D Jtftk ( iiY"ill. I@) Other (Please specify):

2.3 ~~ ~~:bll ~Jllt* Are you applying for express service? tl:: :fm~JIIH ~®!·if .!JHitJ'l, ~:fml&l! ffl . Note: Expre1111!1'vlc:e needsappr11Y81 of 0 ~Yes 0 ~No consular offidals, and extra fees may apply.

2.4 *tX.:fr@~-ff-~tX~~9='m~13M Expected date of your flrst entry Into China on this trip (yyyy-mm-dd)

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2.s fJJ!#-trn~•?X:fi:~~m 1¥.1•-t(~f( Days Longest Intended stay In China among aU entries

BM Date W!tll:tl!!ill: DetaUed address

2.6 :fi:~ liil~tr ft (~II'JraJJ!IiJi./¥, lifl!f.HHl£;1f{~ ) Itinerary in China (in time sequence, may type on separate paper)

2. 7 -$ ~ ~ 1§. :fi: ~ 00 }UJ flij i¥J ¥Jt )fl ? Who wiD pay for your travel and expenses during your stay in China?

~~Bl~¥1\ Name

2.8 ~l:i!lil~ll-1# :l:lt:tll: Address

•1ll:BJG~ .A:rn.m. Information of li*~Et!i!S Inviter In China Phone number

~~ifA'!fr.~ Relationship with the appUcant

2. 9 no:a~~~:ffft~ OO~itt? :!411f, i#istOO:Iilli:-?X~:ff~ OO~iJEI¥3111" fiiJ~:ti!!R. Have you ever been granted a Chinese visa? If applicable, please specify the date and place of the last time you were granted the visa.

2. 10 n-* 12 ~ JJ J:j:l-j;ljfRJI¥J;ltft!!~l(BJG:ti!!JR Other countries or territories you visited In the last 12 months

~' Jtftk:¥:1Ji Part3: Other Information

3. 1 :J! :a '8 :fi: ~ ~ M1. M ~itt Bl ffl Iii i!f liT fc ilf 1¥3 }UJ ~ W Iii ? Have you ever overdayed your visa or D J! Yes D:aNo residence permit in China?

3. 2 :J!:a 'l!f~ftlffi.i!&~£~ OO~iJE. Blftl1ei!&iltA~ 00? Have you ever been refused a visa for China, or D~Yes D:aNo

been refused entry Into China?

3. 3 ;I! :atE ~ 00 BJG ;It ft!! 00 * fl m.@ iG ~ ? Do you have any crlmlnal record In China or any other D~Yes D:a No

country? 3. 4 :J!:a A if!!). r -a:-#·11~ Are you experiencing any ofthe foUowlng conditions? CDF1t:M~~.fi!J Serious mental disorder

D)! Yes D:aNo ®~~ttiDHti~fl1f Infectious pulmonary tuberculosis ®lif*~!e;1!fiHtJJ.1:1¥J;Itft!!~~fl1; Other Infectious disease of pubUc health hazards

3. Slli: 30 B ~ :J!:afl!ttft¥Jifff•[1:~fli;)~~I¥JOO*!l!C;!ik]R? Did you visit countries or territories affected D~Yes D:aNo

by Infectious diseases In the last 30 days?

3. 6:flJL~:t>t 3.1 ~J 3. 5i¥Jif{iiJ-1-fRJIJ~~ "£', iJtETOOW~iJtljlj. If you select Yes to any questions from 3.1 to 3.5, please give details below.

3. 7 WI*:«***¥1Y&mH~-'f:ri'1~~1¥J;ltftk~~iiE$il:ffl:XI¥J$~. il:tE!It!i!G~~~~. If you have more information about your visa applcatlon other tban the above to dedare,please give detaUs below or type on a separate paper.

3. 8 WI $if A~!mlf:t i¥J{lftr A~ $il A -jiiJ.~tr, il~f.'!ltr AJmftf,ljNi:fFfl:fff;Jt:fl~Mtr AWl.@.. If someone else travels and shares the same passport with the applicant , please affix their photos and give their information below.

f~trA 1 f~trA 2 MtrA 3 Person 1 Person 2 Person 3

flftrAffig MMJ!«Jt-FJ/t MJ!Iif!«Jt-FJ/t MJ!Iif!«Jt-FJ/t Information

4/]ixPitoto 4/]ixPitoto A.flixPIJoto II ere llere llere

~-1Zi Full name

fijJ Sex

~B DOB(yyyy-mm-dd)

~, PI~:&.~~ Part 4: Declaration & Signature

4.1 ~p:r~, ~BOO~:Jtl!I!M!It*~:«I*J~~*· :1tiU\1t3Tfli:J!H~g~$if;fitf41¥JJt~fi*m-trJr!-1$m*· I hereby declare that I haw read and understood all the quedions In tbis applcatlon and shall bear all the legal consequences for the authenticity of the information and materials I provided. 4. 2 ~J!I!M, ~~i'f~~~iiL ~~fiiJ;f!l!~i[, A.jj~J!rW.&:«~»J, ~IW.M:W~E8®!$'g.!JHR~. tEfiiJ::f~, ~-'i¥!ilt:!J~::f%ff;I$J m~-'i¥~~-w:E¥~~ffi~!ilt~ffi~*A.If:tm. I understand that whether to issue a visa, type of visa, number of entries, validity and duration of each stay will be determined by consular oftlclal, and that any false, misleading or Incomplete datement may result In the refusal of a visa for or denial of entry Into China. 4. 3 ~J!I!JW, .fljflf:tfit.Mft, $iiA~P1ttif~Jf:tfi~i[i'J~%fmftffif@A.;tt. I understand that, according to Chinese law, applicant may be refused entry Into China ewn If a visa is granted.

... $-iWA~.ti B.M AppUcant' s signature:, •.••.••.••.••.••.••.••.••.••.••.••.••.. Date (yyyy-mm-dd): •.••.••.••.••.••.••.••.••.••.••.•.

~: *nit 18 Jl!J:&: I¥J*Rlt~A@!ffi:$t-BJ:!ilt~~ A-ft~. Note: The parent or guardian shall sign on behalf of a minor under 18 years of age.

Part 5 : If the application form is completed by another person on the I' t' b h If. I till t th • ., ti fth h I te th ti appncan s e a , please 1 ou em orma on o eonew o comp1e s e orm

5. 1 ~.ti Name 5.2 !3$iiA:X~ Relationship with the applicant

5. 3 :f:l!!.itl: Address 5. 4 It 1:5 Phone number

5. 5 ylf l!ij Declaration

~F~;;t;:A~~~$~A~~W~~~~.iiE~$~Al!I!M:Jt~~~Jf:tm~~~~~~x~. I declare that I have assisted in the completion of this form at the requed" of the appUcant and that the appDcant understands and agrees that the information provided is true and correct.

-ft:J;lA~.tiJSignature: .••.••.••.••.••.••.••.••.••.••.••.•. B MIDate (yyyy-mm-dd): ..••.••.••.••.••.••.••.••.•.

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