He XR Se Al OE iE HO Oe Visa Application Form of the People’s Republic of China (For the Mainland of China only) HA Otis, Sai AAAS. URES UOC RH TEN, te OWI. OE te a The applicant should fill in this form truthfully, completely and clearly. Please type the answer in capi English letters in the space provided or tick (\) the relevant box to select. I'some of the items do not apply, please type N/A or None, =. AMA. Part 1: Personal Information — $8 Last name TwuM RRM, RE 1 Full English name | #18144 Middle nan kiss ane mm asinpasspore || | Photo 2, First mame KWAKU Altix one recent cor pastport 12 PRR aeRO hato (al fc, front vow Name in Chinese NA Other name(s) NA barobeded and again pain soe Ugh colored background. 1.4 #8) Sex ym Oke pote amas) 1997-04-09 16 RA Conatationaiyie) __ GHANAIAN 1.7 $84YEBLRE Former nationality(ies) NA 18 Haw ACH. AA BD Place of birth(cty, province! state, country) KORLE-BU, ACCRA-GHANA 19 SEA RE TE Local IDy Citizens 1449104411 1.10 RT EAE [IP Diplomatic [29 BAservice oF Orci PassportTravel document type fl Ordinary [setiizercmiten omer ease specify: 1 FR 112 ERE Passport number 62188362 Date of isue(yyyy-mm-dd) 2018-10-02 13 BA 11 Place of ise ACCRA Date of expiey(yyyy-tam-ad) 2023-10-01 tA Businessperson [iti Formerfincumbent member of parliament [J24RA Company employee WRAL Position (mE Aw Entertainer (Clare tence. Formeriincumbent government official (DVR industriav/Agricutturat worker WRAL Position 1.15 80 student itary personne! CnReaD JE Stude Coe min ps Curent [RAB crew member Witt Postion, oceupation( [Am settemployed (secs. NGO stat [Tix Uncemployed [Tet A+ Retigious personnel Diet Retired (Data AWAR Staft of media [se ticat tan) otter (Pease specify): 1.16 BEEBE (Lats: Postgraduate [Dx* cottege Education [SecA BEB) Omer (Pease specify): WEST AFRICA SNR SEC. CERTIFICATE EXAM, 2k BoE harfeattowee | NeweST. THOMAS AQUINAS SNR. HIGH SCHOOL) FySne Samper (030) 277-6801 Employer/School | jst =~ P.O, BOX 0101, CANTONMENTS-ACCRA | scsi} 00233 Address Zip Code BLES ELAR 1M am sragettsLABONE FIRST BUNGALOW ree (GL-015-1136) meee 00233 Tee eA (057) 738-8550 Home/mobile phone number 1218 F868 WEKUTWUMS9@GMAIL.CO E-mail address 1.22 464090 Marita status [[] Eh Married 4 single C] Sef OMher(Please specify) 16% Name HG Nationality 1.23 BEER BRU Occupation 28H Relationship RB. Fe. 288.003) | AGARTHA MIREKUAA GHANAIAN TRADER MOTHER Major family members(spouse, children, TwuM parents, ete may type on separate paper) ee Name 124 panenee. EBENEZER ANNAN 7H Mobile phone number (020) 819-7244 Emergency SAR Contact Relationship withthe applicant UNCLE 1.25 HEA RE WEEN ATAE MS LRBLIGL Country or territory where the applicant is located when applying for this visa GHANA =. RATA Part 2: Travel Information DD Bal ones (1 2 Tourism Ly 2a, 48. WHIT Non-business visit 1 ae51e Business & Trade Visit 11 A+ ai As introduced talent [1 TRH As crew member (Dees. ocr, Bap A Asresident diplomat, consul or staf of international orgar [XA BBB As permanent resident Lt work [1 #99 As enita in foster care [1 8t88 Transit 2.1 HSE | 7) erat es ECA A [SPEAR Ra AAT AD RA Major purpose "hiticehn CIPI) | AGHRUH WABRELSOE Family reunion for over 180 ofyourvist | AFBLA Short-term sit Chinese citizen or foreigner |, Chinese ciizen or frsignr with Chinese with Chinese permanent residence status permanent residence status (monte rte. eeraardes mere aD |] Kommiana Cte, er asaceceoh MENA A HBA Short-term visit to foreigner residing in China | As accompanying family member of foreigner residing due to work, study or other reasons in China due to work, study or other reasons (1) 921 short-term study for tess than 180 days |[7] 4OPRSI Long-term study for over 180 days [aR Daten As Journalist for temporary news coverage ‘As resident journalist 1 xtecavem other (Please specify): —K(BBRZ A 3 SAAKO One entry valid for 3 months from the date of issue aa ae sae Ld eR a 5-6 6400 To coin vall for 30 6 months from the dat of sue Intended number | [_] #4FS% (HERZ Hie 6 TAA Multiple tries valid for 6 months from the date of issue tenis CC) rae CHRRZ BG AED Mn le ent valid for 1 year from the date of issue 1 2s GARD Omer (Please specify): 23 RAMI BLS Are you applying for express service? 2 MER ACACN NAM, inde Noe: Express service needs approval of consular officals and extra fees may apply O&yes B No 24 RT AEE SE Expected date of your first entry into China on this trip (yyyy-mm-dd) 2019-09-10 2H Raw svagezets2.5 BLT EEA RI Longest intended stay in China among all entries 360 Days Have you ever heen refused a visa for China, or heen refused entry into China? FM Date ‘PLE Detaled adress 7019-08-10 DEPARTURE FROM GHANA (KOTOKA INT. AIRPORT) 20 fe RE 2 CRN, BM, 5-00-11 ‘ARRIVAL IN BEWING (PEK) AIRPORT Itinerary in china intine | >o49.g9-12 DEPARTURE FROM BEWJING TO YANTAI AIRPORT (SHANDONG) type on separate re) 2019-0942 TO SHANDONG TECHNOLOGY AND BUSINESS UNIVERSITY 227 RRL PAA ‘Who will pay for your travel and expenses during your stay in China? MOTHER ema SHANDONG TECHNOLOGY AND BUSINESS UNIVERSITY vn NO. 191 BINHAI MIDDLE ROAD, YANTAT, 28 RAR | Areas SHANDONG RAR Information of | egg 05356708675 inviterin China| ORAS BRHARR Relationship with the applicant STUDENT 29 MBM HATE? rh, WTAE UR PERE FORMA. Have you ever been granted a Chinese visa? If applicable, No please specify the date and place of the lst ime you were granted the vse, 20s 12 “SA a SHO Other countries or tervitores you visited in the lat 12 months NA =. SUbS0H_Part 3: Other Information eet ; Fave you over overstayed your vin or rskdvace pert in Chins? Dave Wane 32 RACRERER GREE REA ves [No 33 AE PRIMERA IER? Do you have any eriminal record in China or any other country? BNo 3.4 BILAL PEEP Are you experiencing any of the following conditions? @P*RHFIEEE Serious mental disorder /ou visit countries or territories affected by infectious diseases in the last 30 days? Q#ESeHEHKEBER Infectious pulmonary tuberculosis Dike ano OAM ATE LALA ITHLERLAT Other infectious disease of public health hazards 3.536 30 BRANT HBO SRO IED Deve aw 36TH TA”, we Ifyou select Yes to any questions from 3.1 to 35, please give details below. 2H am ragedTT HRAREAV AAR G ECR SEPA ON, WEAR. If you have more information about your visa application other than the above to declare, please give details below or type on a separate paper. NA 3.8 SOR ARRAY AT ASA — REET, NEAT ABUT RE F PSUS AAT AL. Isomcone else travels and shares the same passport with the applicant, please affix their photos and give their information below. MTA 1 MATA 2 MTA 3 Person 1 Person 2 Person 3 Palin PERT tt BARTER PEROT Ft ‘Affix Photo “Affs Photo ‘Affix Photo here there here 7 Full name 5 Sex #5 DORyyyy-mm-dd) Wl. WRB Part 4: Declaration & Signature 41 2FE, ROMER ATER, ESAT RAMA OR CREE. Thereby declare that I have read and understood all the questions inthis application and shall bear all the legal consequences for the authenticity of the information and materials I provided. 42 RAM, ERR. RAMS. KRUTAIR, SRO IE, ENTS. ROAR TREY Te ARCEMIS. Tunderstand that whether (o issue a visa, type of visa, number of entries, validity and duration of exch stay will be determined by consular official, and that any false, misleading or incomplete statement may result inthe refusal of a visa for or denial of entry into c a, ALTER, HN A UD MRA BARE OSA eH Tunderstand that, according to Chinese law, applicant may be refused entry into China even ifa visa is granted. => EER BM 2019-08-15 Applicant's signature: Date (yyyy-mm-dd)y Es RM 18 MP ARIE AT SCFM AFUE, Note: ‘The parent or guardian shall sign on behalf of a minor under 18 years of Ey Ah AACBOH AERIS AES LF AV Part S: If the application form is completed by another person on the applicant's behalf, please fill out the information of the one who completes the form. 52 5H WARE S184 Name NA Relationship withthe applicant NA 5.3 Heh Address NA 5.4 48% Phone number NA 55 Fl Declaration BEARER ASR TTI, TOT ABA TEH TS WEAR. I declare that I have assisted in the completion of this form at the request of the applicant and that the applicant understands and agrees that the information provided is true and correct. RAABL/Signatures Mate (yyyy-mm-da): eH aw sragesets