One photo to Please Indicate Type of Visa Requested

glue and other □ Diplomatic Visa

one to staple on □ Official Visa Tick on the
glued one. □ Courtesy Visa appropriate
Please attach
□ Non-Immigration Visa Category
2 photographs □ Tourist Visa
APPLICATION FOR VISA □ Transit Visa
taken within
the last 6 months Royal Thai Embassy, Dhaka Number of Entries Requested _______
(3.5 x 4.5 cm)
Write number of Entries e.g. 1 / 2
AAA BBB CCC
□ Mr. □ Mrs. □ Miss _______________________________________________________________________________________
First Name Middle Name Family Name (in Block letters)

Write if any or N/A if not applicable

Former Name (if any) ___________________________ Countries for which travel document is valid _________
BANGLADESHI for Bangladeshi Passport Holder or Nationwise
Nationality ____________________________________ ''ALL COUNTRIES EXCEPT ISRAEL" for Bangladeshi Passport.
_____________________________________________
As per passport
Nationality at Birth _____________________________ Proposed Address in Thailand ____________________
As per passport. Marital Status Write
Birth Place ___________ ____________
marital status If not specified, provide any hotels name & address.
_____________________________________________
As per passport
Date of Birth __________________________________ Name and Address of Local Guarantor
PASSPORT
Type of Travel Document________________________ Any person is name who know you very well and not
_____________________________________________
No. ______________ As per passport.
Passport Number Issued at ____________________ applying for visa together.
_____________________________________________
Date of Issue _____________ As per passport.
As per passport. Expiry Date __________ Phone number of local guarantor which is reachable.
Tel./Fax. _____________________________________
Occupation (specify present position and name of employer) Name and Address of Guarantor in Thailand _________
Current designation, organization name. If student; class name
_____________________________________________ Any person in Thailand who know you very well and informed
_____________________________________________
_____________________________________________
then Educational institutions _____________________________________________
about your current travel plan. If don't have write "N/A"

where applicant currently staying

Current Address _______________________________ Tel./Fax. _____________________________________
Contact details if have or N/A if not.

_____________________________________________ I hereby declare that I will not request any refund from my
paid visa fee even if my application has been declined.
Tel. Active Phone Number E-mail _____________________
______________ Active email ID
Applicant's sign as per passport Date _______________
Submission Date
Signature ___________________
As per passport
Permanent Address (if different from above)_____________
if current & permanent address same write Attention for Tourist and Transit Visas Applicants
_____________________________Tel.
"SAME AS ABOVE" Active Phone Number
____________ I hereby declare that the purpose of my visit to Thailand
Names, Dates and Places of Birth of minor children is for pleasure or transit only and that in no case shall I engage
If child endorsed in passport and applying for Visa,
myself in any profession or occupation while in the country.
(if accompanying) __________________________________________ Same sign as above, if applying for Tourist, Medical, Transit
Submission Date
Signature _________________ Date ________________
or put N/A for not applicable
__________________________________________________________
Date as per PNR
Date of Arrival in Thailand _________________________
FOR OFFICIAL USE
Date as per PNR
Traveling by ____________________________________
Application/Reference No. _____________________
Flight no. as per PNR
Flight No. or Vessel Name _________________________ Visa No. _____________________________________
Duration as per PNR
Duration of Proposed Stay _________________________ Type of Visa:
Date as per passport,
Date of Previous Visit to Thailand ___________________
or N/A if not applicable
□ Diplomatic Visa □ Official Visa □ Courtesy Visa
Purpose of Visit: □ Tourism □ Transit □ Business □ Non-Immigration Visa □ Tourist Visa □ Transit Visa
Tick the correct purpose and write hospital's name, if for medical treatment Category of Visa: ___________________________________
□ Diplomatic /Official □ Other (please specify) __________
or program's name if for attending program. Number of Entries:
FOR OFFICIAL USE ONLY □ Single □ Double □ Multiple □ ___ Entries
□UG □PP □AF □RD □ Multiple □ Other __________________________________ Date of Issue ________________ Fee __________________
□GPV □CAF □STH □SES □FIT □GPT □GFL □NRR □ Other _______________ Expiry Date _______________________________________
□FVP □IAF □FP □NF □OT □ECBS □ECWC □ECFL □CI □RR □FPT □SN Documents Submitted _______________________________
□HT □WP □ Other _____________________________________________________ _________________________________________________
□P □F □SR □RC □MFA □WP3 □PPP □PAF □TRC □ITV date
□A □R □VL □WL □BL Authorized Signature and Seal ____________________
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