Instruction for filling out Visa Application Form V.2013
(only use the link on my website, as the Chicago Consulate has made
the font size of certain fields, when typed, very large, to prevent eye strain)

Adopting Families and their Travel Mates & Heritage Tours Only

Part 1: Personal Information 
1.1   Your full name:   Last name   Middle name   First name

PHOTO:  attach 1 color passport type photo 2”x 2” with GLUE only
               in the square box to the right of 1.1 to 1.5 with the word Photo in it
               [DO Not trim photo to fit]

1.2   Chinese characters if born in China*
       *For all previously adopted children (even if they have been back to China),
         leave this blank and send a copy of the Chinese Passport picture/info page.

         I also need the actual Chinese Passport if it is your first trip back to China.

         If this is not your first trip back but the Chinese passport was never marked
         cancelled and pages clipped, you will need to send the Chinese passport.

         If born in China and not first trip back, send a copy of the prior China visa,
         if prior visa is not in current passport.

1.3    Other Name(s):   maiden last name or Chinese pinyin for those born in China
        (if applicable)
1.4    Select your gender 
1.5    Date of birth:  (yyyy-mm-dd
1.6    Your current nationality  (example: American, Canadian)  
1.7    Your former nationality  (if applicable).  If born in China, put Chinese.
1.8    Name of your birth place (City, State and Country)
1.9    Your local ID number (Drivers License or State ID,
        NOT SSN or Immigration number (leave blank for minor children)

1.10  Type of your passport (if type P, check "Ordinary")
1.11   Passport number 
1.12   Passport issue date (yyyy-mm-dd
1.13   Passport issue place: put “US Dept of State”
1.14   Passport expiration date (yyyy-mm-dd

1.15  Your current occupation:
        ~  If your occupation is not listed, check "Other" and specify

        ~  If Self-Employed, check Self-Employed and also check “Other” and give
            your title and type of business

        ~  For children not in school, check “Other” and put minor child

        ~  For children Home Schooled, check “Student” and put Homeschool in 1.17
            along with your home address and phone number

        ~  If you work for the media, press, or are a writer, editor, reporter or
            photographer call me to discuss (815) 690-7035 before sending
            application, as there will be limitations to your visa.

        ~  If you work for a religious organization or there is a religious word in the
            company name [not children’s Schools name, or Hospitals name]) call me to
            discuss (815) 690-7035 before sending application, as there will be
            limitations to your visa.

        ~  Military Personnel will be given at most a 1 year visa. 
            Check Military Personnel and put your Rank/Position.

1.16  Select Education Level (for children put the grade level, if not in school,
        put N/A)

1.17  Name, full mailing address and phone number of your current employer or
        current school (no P.O. Box’s, exact address only).  Also do not put initials
        (unless that is the name), write out the complete name.  After you print the 
        application make sure this info printed, sometimes city and state are left off.

        For Self-Employed, put your company name, if you have one, or your full name. 
        Your full business address and business phone number, if you have one, or
        full home address and phone number (no P.O. Box’s, exact address only).  

        For Minor Child not in School, Unemployed, Retired, Homemaker, Housewife,
        Househusband, Domestic Engineer, or Goddess put N/A.

1.18  Your full current home mailing address (no P.O. Box’s, exact address only)
        After you print the application make sure this info printed, sometimes city and
        state are left off.

1.19  Your home zipcode
1.20  Your home or mobile phone number
1.21   Your email address (optional)
1.22  Your marital status 

1.23  Information for only the family members living in your home 
        (if you live alone, you must list 1 relatives info)

         If you have more people than lines provided, hand write the info on the back
         of page 2 (black ink only), do not put on a separate piece of paper.

1.24  Your contact person in case of emergency while in China
        (this is a relative or friend in the USA or can be your agency representative) 
1.25  Put “USA”

Part 2: Travel Information 
2.1   Select the purpose of your visit to China 
       (check Tourism and in "Other” put Adoption: <family last name> Family or
                                                      Heritage Tour: <family last name> Family)
       if the application will not let Tourism & Other be checked at the same time,
       check “Other” with a black pen. 

       Example:    Adoption: Smith Family     Heritage Tour: Jones Family

Adoption:  Send a copy of your “LOA” (Letter of Seeking Confirmation
                               from Adopter (not TA) with each visa application submitted. 
                               Staple the application (left top corner) with the LOA as the
                               last page of the application.

       For Heritage 
                   Tour:   Send a copy of your “Invitation Letter” with each visa
                               application submitted. Staple the application (left top corner)
                               with the Invitation Letter as the last page of the application.
2.2  Select “Other” and put “10 Year” for the number of entries for this visa if
       you have over 12 months left on your passport.  Contact me (815) 690-7035
       if there is less than 12 months left on the passport. 

2.3  Check "No"

2.4  Date of your first entry for this trip (yyyy-mm-dd)
       (put the word “Estimate” after the guesstimate, if you do not know the exact
        travel date).    

       Example:   2015-8-01 Estimate  or 2015-11-15 Actual

2.5  Longest intended stay of your visit in China: 
       (put 30 days, contact me if you intend to stay longer than 30 days)
2.6  For Adoption: Put the “estimated date” and only the HOTEL name
       in Guangzhou that your agency uses, on the first line, along with the phone
       number (nothing else).  You can visit any mainland China city with your visa.
          yyyy-mm-dd Estimate          China Hotel    – Guangzhou  ph: 020-866-66888
          yyyy-mm-dd Estimate          Garden Hotel – Guangzhou  ph: 020-833-38989
          yyyy-mm-dd Estimate  White Swan Hotel – Guangzhou  ph:  020-818-86968
          yyyy-mm-dd Estimate         Victory Hotel – Guangzhou   ph:  020-812-16688
       For Heritage Trip: Put the “actual date” and each hotel.  If you have more
       hotels than lines provided, hand write additional hotels on the back with
       black pen.

           yyyy-mm-dd Actual         Crown Plaza Lido – Beijing       ph:  010-643-73388
2.7  List who will pay for your cost of traveling and living during your stay in China
       examples:  Myself, Parents 

2.8  Name, address and phone number of your inviter or contact unit in China
       For Adoption put:  CCCWA – China Center of Children Welfare and Adoption
                                     Beijing, China 
                                     ph: 010-655-45199
       For Relationship with applicant put:  Adoption

       For Heritage Tour put:  Inviter name, address and phone number 
       For Relationship with applicant put:  Tour Operator

2.9  If you have never visited China put “No”. 
       If this is the first visit back for an adopted child, put “No”.
       If Yes, put issue year and month (yyyy-mm) of your last visit, and compare the
       symbols in the previous instructions to find the place your last visa was issued.
       (for some crazy reason I cannot put the pictures of the Consulate names on this
        page.  Until I figure it out, they are in the main instructions).

       example:  2004-05  Chicago    2007-10  Washington, D.C.     2010-01  Houston

2.10  List date (yyyy-mm) and name of other countries or territories, you have
        visited in the last 12 months. If none, put “None”.

        example:  2014-02  Israel    (yep, I went there and it was awsome!)   

Part 3:  Other Information
3.1  Select "Yes" or "No" if you have ever overstayed your visa or residence permit
      in China 
3.2  Select "Yes" or "No" if you have ever been refused a visa or refused entry
       into China 
3.3  Select "Yes" or "No" if you have any criminal record…
3.4  Select "Yes" or "No" if you are affiliated with any of the following conditions… 
3.5  Select "Yes" or "No" if you visited countries or territories infected by
       infectious diseases in the last 30 days 
3.6  If you select "Yes" to any questions from 3.1-3.5, give details. 

       If you check yes to question 3.1 thru 3.5 call me to discuss (815) 690-7035
       before sending me your visa application, as your visa will be limited.

       If you check yes to 3.3 you will need to provide the court documents and a
       signed letter (mea culpa) explaining the details of the crime.

       If you check yes to 3.3, do not ask me if such and such is a crime, or say
       it happened 10, 20 or 30 years ago, or say it is now expunged.  I will not give
       my opinion… except to ask “is it in your homestudy?” 
       A hint to the wise is sufficient.

3.7  Additional information
3.8  Leave Blank

Part 4: Declaration & Signature 
        Sign and date (yyyy-mm-dd)
        (if application is for a minor child, under 18 yrs old, parent will sign and date
        Part 4 and go to Part 5) 

Part 5: Declaration & Signature
If this application form is completed by another person on the applicant’s
         behalf (must fill out for minor children), complete section 5

5.1  Name of the person who completed this application form 
5.2 Relationship to the applicant
5.3 Full Address of the person who completed this application form 
      (no P.O. Box’s, exact address only)

5.4 Phone number of the person who completed this application form 
5.5 Signature and date (yyyy-mm-dd) of the person who completed this application
      for another person

 Note:  Information subject to change at any time (revised 11/2018)

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