Please Indicate Type of Visa Requested

□ Diplomatic Visa
□ Official Visa
Please attach
□ Courtesy Visa
1 photographs
2
taken within
□ Non-Immigration Visa
the last 6 months □ Tourist Visa
APPLICATION FOR VISA □ Transit Visa
(3.5 x 4.5 cm)
Royal Thai Embassy, Dhaka 1
Number of Entries Requested _______

□ Mr. □ Mrs. □ Miss _______________________________________________________________________________________

First Name Middle Name Family Name (in Block letters)
N/A
Former Name (if any) ___________________________ Countries for which travel document is valid _________
BANGLADESHI
Nationality ____________________________________ ALL COUNTRIES
_____________________________________________
BANGLADESHI
Nationality at Birth _____________________________
SAMALA HOTEL BANGKOK
Proposed Address in Thailand ____________________
MARRIED
Birth Place ___________ Marital Status ____________ 43 SOI SUKHUMVIT 15, SUKHUMVIT ROAD, WATTANA
_____________________________________________
Date of Birth __________________________________ Name and Address of Local Guarantor
INTERNATIONAL PASSPORT
Type of Travel Document________________________ _____________________________________________
DHAKA
No. ______________ Issued at ____________________ _____________________________________________
Date of Issue _____________ Expiry Date __________ Tel./Fax. _____________________________________
Occupation (specify present position and name of employer) Name and Address of Guarantor in Thailand _________
_____________________________________________ N/A
_____________________________________________
_____________________________________________ _____________________________________________
Current Address _______________________________ N/A
Tel./Fax. _____________________________________
_____________________________________________ I hereby declare that I will not request any refund from my
paid visa fee even if my application has been declined.
Tel. ______________ E-mail _____________________
Signature ___________________ Date _______________
Permanent Address (if different from above)_____________
Attention for Tourist and Transit Visas Applicants
_____________________________Tel. ____________ 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
NA myself in any profession or occupation while in the country.
(if accompanying) __________________________________________
Signature _________________ Date ________________
__________________________________________________________
Date of Arrival in Thailand _________________________
FOR OFFICIAL USE
THAI AIRWAYS
Traveling by ____________________________________
TG-340 Application/Reference No. _____________________
Flight No. or Vessel Name _________________________ Visa No. _____________________________________
7 DAYS
Duration of Proposed Stay _________________________ Type of Visa:
NA
Date of Previous Visit to Thailand ___________________ □ Diplomatic Visa □ Official Visa □ Courtesy Visa
Purpose of Visit: □ Tourism □ Transit □ Business □ Non-Immigration Visa □ Tourist Visa □ Transit Visa
Category of Visa: ___________________________________
□ Diplomatic /Official □ Other (please specify) __________ 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 ____________________
1 2 3 4 5 6