Travel Information 旅行信息
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NOTE: Provide the following information concerning your travel plans. 注意： 请提供以下有关您旅行计划的信息 Provide the following information: 请提供以下信息： Purpose of Trip to the U.S. 赴美访问目的 Specify 具体说明 Have you made specific travel plans? 您是否已经制定了详细的旅行计划？ Intended Date of Arrival 计划达到日期 Intended Length of Stay in U.S. 计划在美停留时间 Street Address (Line 1) Street Address (Line 2) *Optional City State TEMP. BUSINESS PLEASURE VISITOR(B) 临时商务及旅游 B2 商务/个人访问(B1/B2) No Yes No 15 OCT 2011 20 DAYS 222 South. Mountain View Ave. Pomona CALIFORNIA Address Where You Will Stay in the U.S. 在美停留期间的住址 ZIP Code (if known) (e.g., 12345 or 91888 12345-1234) Person/Entity Paying for Your Trip 支付您旅Self 行费用的个人或组织名称 -Select One- Self U.S. Petitioner Other Person Other Company/Organization .. Travel Companions Information 随行人员信息 NOTE: Provide the following travel companion information. 注意：请提供以下随行人员信息。 Persons traveling with you 与您同行的人 Are there other persons traveling with you? 是否有人与您同行？ No Help: Traveling with Others 与其他人同行 You should answer Yes to this question if you are traveling with family, as part of an organized tour, or as part of a performing group or athletic team. You do not need to list individuals who are traveling with you for the purposes of employment with the same employer. 如果您是与家人同行，或作为旅行团组的一部分，或一表演/体育团组的一部分，您对这个问题的回答应该“是”。这些和您一起旅行的人员是赴美为同一雇主工作,您不用列举他们的名字。 Previous U.S. Travel Information 以往赴美旅行信息 17
NOTE: Provide the following previous U.S. travel information. Provide complete and accurate information to all questions that require an explanation. 注意：请提供下面关于以前赴美旅行的信息。对于所有要求解释的问题，请提供完整、准确的信息。 Have you ever been in the U.S.? 您是否曾经在美国停留过？ Have you ever been issued a U.S. Visa? 您是否曾经获得过美国签证? No Yes No No Yes No Have you ever been refused a U.S. Visa, been No Yes No refused admission to the United States, or withdrawn your application for admission at the port of entry? 您被拒签过吗？ 或在入境口岸被拒入境，或被撤销入境申请？ Has anyone ever filed an immigrant petition on No Yes No your behalf with the United States Citizenship and Immigration Services? 曾有人在公民及移民服务局为您申请过移民吗？
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U.S. Point of Contact Information 美国联系人信息
Contact Person or Organization in the United States 在美国的联系人或组织 Help: Contact 联络人
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Your U.S. Point of Contact can be any individual in the U.S. who knows you and can verify, if necessary, your identity. If you do not personally know anyone in the U.S., you may enter the name of the store, company, or organization you plan to visit during your trip. 您的美国联络人可以是任何在美国的个人。他/她认识您，如有需要，并可以证明您的身份。如果您在美国没有认识的人，您可以输入您此行将要访问的商店、公司或者组织的名称。 Contact Person or Organization in the United States 在美国的联系人或组织 Contact Person 联系人 Surnames 姓 Given Names 名 RELATIVE 联系人关系 .Do Not Know Lee Cort SPOUSE 配偶 FRIEND 朋友 BUSINESS ASSOCIATE 商务伙伴 EMPLOYER 雇主 SCHOOL OFFICIAL学校官员 OTHER 其他 FRIEND 朋友 Do Not Know 222 South. Mountain View Ave. POMONA CALIFORNIA 91000 6265555858 cort@yahoo.com Relationship to You 与您的关系 Organization Name 组织名称 U.S. Street Address (Line 1) 美国地址1: U.S. Street Address (Line 2) *Optional 美国地址2 （可选） City 城市 State 洲 ZIP Code (if known) 邮政编码 Phone Number 电话号码 Email Address 电子邮箱 Family Information: Relatives家庭信息：亲属
Contact Person or Organization in the United States 在美国的联系人或组织 Address and Phone Number of Point of Contact 联系人的地址和电话号码
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