以色列签证表

1、.申请表填写说明： Instructions for completing application form: 1. 请附近期护照照片一张。1. Please attach a recent photograph.2.如不是因为访问以色列而提交辞申请，请详述原因并递交相关材料。2. If application is not for the purpose of visit, specify reasons and supply documentation.3.请用希伯来文或者英文填写3. Please fill in following details in Hebrew or Englis

2、h.姓Family name名Given name父亲姓名Fathers name母亲姓名Mothers name曾用名Previous family name出生地点Place of birth出生日期Date of birth职业Occupation现国际Present nationality曾有国籍Previous nationality婚姻状况Family status 护照 Passport Laissez passer 临时通行证件 未婚 已婚离异 丧偶护照号码number签发地点Issued at签发时间Issued on有效期至valid until married singl

3、e widowed divorced进入以色列的目的Purpose of entry into Israel , .若持永久居留国签发的临时通行证件，请说明是否具有回程签证及签证有效期。国定居留地址 permanent address abroad 国家Country城市City街道以及门牌号Street and house no.电话号码telephone no.在以色列的地址 Address in Israel 拟入境日期及地点Anticipated date and place of entry to Israel拟停留期限Approximate duration of stay 中转国

4、Countries of transit曾在以色列停留日期Dates of previous stays in Israel曾入境以色列的许可类型（访问；学生；旅游；临时居留；移民；工作）Category of previous residence permit (visitor, temporary resident, resident, immigrant, work)申请人随行家属详细情况particulars of dependants included in the application配偶spouse姓family name名given name婚前姓maiden name父亲姓

5、名fathers name出生地点place of birth出生日期Date of birth岁以下未成年人18Children under the age of 18姓名Given name出生地点Place of birth出生日期Date of birth1.2.3.以色列联系人/亲属Relation/references in Israel姓名name关系relationship地址address1.2.声明declaration1.我声明，以上申请表中所填写的所有信息均属实，并将作为审核申请的依据。我无任何危害犹太人民或以色列国安全的犯罪记录，且没有任何危害公共健康的疾病。我无任何

6、司法限制，也未被任何国家的警方通缉。2.我声明，我没有受到任何出行限制，也未曾被以色列禁止入境，我知晓若因我受到此类的限制，我将会被拒绝入境并遣送回原籍国。3我知晓若我填写虚假信息即使申请得到签证，一旦查明，以色列内务部将仍有权力拒绝我入境以色列。1. I declare that the particulars contained in this application are correct and have been made in awareness of the fact that they are to serve as basis for the consideration of

7、 my application. I also declare that I have not committed any criminal offence or any act directed against the Jewish people or the security of the state of Israel and that I am not affected with any illness which might endanger public health. There is no judicial warrant against me and I am not wan

8、ted by the police of any country.2. I hereby declare that I have not been issued with a restraining order. Furthermore, I have not been denied entry into Israel. I am aware that if a preventive order of this kind has been issued against me, I will be denied entry into Israel, and will be sent back to my country of origin.3. I am also aware that the receipt of a visa does not in any way invalidate the right of the Israel Ministry of the Interior to deny my entry into the territory of the Sta