Vietnam Visa Application form

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| Vietnam Hotels |

VIETNAM VISA SERVICE REQUEST FORM

Visa Information
Service require
Request	Normal processing Urgent
Your Title *
Passport Name *	Please fill name exactly same as in your passport
Date of birth *	(dd mmm yyyyy, like 01 May 1980)
Nationality *
Passport Number *	(valid at least 6 months)
Passport Date of issue *	(dd mmm yyyyy)
Passport expiration date *	(dd mmm yyyyy)
Proposed date of arrival *	(dd mmm yyyyy)
Flight Ref & Arrival time
Port of Arrival
Purpose of visit
Vietnamese Embassy or Consulate's city, where you plan to get visa	(for visa approval code only)
Contact Information
Email address *
Address where we can contact you
Tel and Fax
Remarks
How did you learn about this service?
Which Vietnamstay.com page did you visit first?

A copy of this booking will be sent to your email address; in case you do not receive that email,
please write to us at visa@vietnamstay.com. Thank you.

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