1625 K Street NW Suite 750 Washington DC 20006 T el: 888 838 4867 ♦ Email: S I LVE RSE A @PinnacleT DS.com Visa requirements shown below are for U.S. citizens ONLY. Nationals of all other countries please contact Pinnacle Travel Document Systems directly for specific requirements for your itinerary.

Cambodia & Mysteries of Angkor Wat Land Program

Visa(s) Req’d

Cambodia

# Forms

1

# Photos

1

Cost 1 – Persons - 2

$ 150.00

$270.00

Application Deadline 30 days prior to your departure

Expedite Fee Per Person

$90.00

Cost for each person beyond the first two will be $120.00 Please use the enclosed sample information verbatim and substitute your personal information.

Fees shown above include all necessary consular and service fees as well as the cost to return your passport(s) via FedEx within the continental U.S. (Please add $30.00 to cover extra shipping costs for addresses in Alaska, Hawaii, or Canada.) We strongly suggest that you send your documents to us via FedEx or some other form of traceable overnight courier service. Please enclose your actual passport along with one (1) photograph, and one (1) completed visa application form for Cambodia. Please also include two (2) photocopies of the vital information page of your passport. Photographs should be recently shot passport-type photos with a clear background approximately 2” x 2” in dimension. (Note that machine or home digital photographs are not acceptable and photographs must be different than those in your current passport.) Your passport must be valid for a minimum of six (6) months beyond the completion of your travel and must have at least two (2) blank unused pages available not including those reserved for amendments and endorsements at the back of your passport. Contact PTDS directly for assistance with the renewal of your U.S. passport, as this can easily be done at the same time you apply for your visa. Applications must be received in our offices no fewer than 30 days prior to your departure from your shipping address. Documents received after the deadline will be subject to the per person expediting fee shown above. (Please do not send your documents more than 90 days prior to your entry to Cambodia due to limited validity of the visa.) Special requests for passports to be expedited due to other travel plans prior to your tour departure may also require expediting fees. Please contact PTDS directly regarding any special processing needs or before submitting documents you expect may be received substantially after the deadline as there may be special requirements and/or additional fees to process your request. It may not be possible to cancel processing of your applications once they have been submitted. Please note that consular fees, shipping fees and application requirements are subject to change without notice. Check and credit card payment accepted. Credit card payment subject to 3.5% surcharge.

PLEASE BE CERTAIN TO RETURN THE FOLLOWING TO: Pinnacle Travel Document Systems 1625 K Street NW Suite 750 Washington DC 20006 ♦Your actual passport (Please keep a photocopy for your records.) ♦This completed form ♦ Two (2) photocopies of the vital information page of your passport ♦ One (1) completed visa application form per person for Cambodia ♦ One (1) passport-type photograph per person (Please leave loose, PTDS will affix.) ♦ Credit of debit card authorization below

P LEASE PRINT CLEARLY Full Name: ________________________________

Full Name: ________________________________

Passport #: ____________________ Exp: ___/___

Passport #: ____________________ Exp: ___/___

Home

________________________________

Home Tel: ________________________________

M ailing

________________________________

Work Tel: ________________________________

Address:

________________________________

Email: ____________________________________

________________________________

Date of Departure from Home: ____/____/_____

Mo

Yr

Mo

Month

( Fe dE x ca nno t d eli v er t o P O b ox e s )

Day

Yr

Year

Ad d r e s s

________________________________

Tour Name: Cambodia

F or Re tu rn

________________________________

Date of Sailing:

________________________________

Special Instructions: ______________________

P a ss po r t:

________________________________

_________________________________________

Tel:

________________________________

_________________________________________

Of

Month

/

Day

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Year

Pl e a se ind ic a t e b el ow if the r e a re k now n pe ri od s p rio r to yo u r to ur du rin g w hic h yo u w ill ne e d yo u r pa s sp or t f o r an ot h er in t er na ti on al tr ip or w he n yo u w ill n o t b e a va il abl e to si gn for th e re tu rn of yo u r p a s spo r t.

I w ill n e ed m y p a s spo r t ( s) f o r o t he r i n te rn a ti on al tra ve l fr om

_____/____/_____ to _____/____/_____

I w ill no t b e at m y h om e an d/o r r et ur n shi ppi ng ad dre s s from

_____/____/_____ to _____/____/_____

Mo nt h

Mo nt h

Day

Year

Day

Year

Mo nt h

Mo nt h

Day

Day

Year

Year

CREDIT CARD AUTHORIZATION: A M E X / V I S A / M C (please circle one) Cardholder Name: _ _ __ _ _ __ _ __ _ _ _ __ _ _ __ _ Si g nat u re: _ ___ _ _ _ __ _ _ __ _ _ __ _ _ __ _ Bil lin g Z ip Co d e: __ _ _ __ _ _ __ _ __ Card #: _ _ __ _ _ __ _ _ __ _ _ __ __ _ _ _ __ _ _ __ _ _ _ CI D# _ _ __ _ __ _ _ _ __ _ _

Expires: _ __ _/_ _ _ Mo

Yr

Amount: US$ __ _ _ __ _ __

FOR OFFICE USE ONLY

SI LVE RSE A L AND C AM BODI A 2 0 1 6 ( Cambo di a4 5 )7 5 F X3 0 1 50 /2 7 0 P GS 2  2 0 16 – Pin na cl e Tr a v el Do c ume nt S ys t e m s

V AL 6M O S DL 3 0 D AYS 90 .0 0

ONLINE ORDER COMPLETION & AUTOMATED UPDATES: If you have not already done so please complete your order online. This will allow you to create an inbound FedEx shipping label to securely send your documents to us and pay all required fees online. This will also allow you to receive automated email updates regarding the progress of your documents. Please locate and click on the name or number of your specific program at the link below to complete your order. www.PinnacleTDS.com/Silversea

IMPORTANT NOTICE - PASSPORT PAGES & VALIDITY: You must have at least two (2) blank unused pages available in your passport for visas and entry/exit stamps. In addition, your passport must be valid for six (6) months beyond the completion of your international travel. If you are a U.S. citizen and do not have the adequate number of pages or validity you will need to renew your passport since the U. S. Passport Agency will no longer add pages. Pinnacle Travel Document Systems can easily assist you with this at the same time your visas are being processed. The total additional fees for this service (including U.S. government expediting fee) is $264.00 for passport renewals and second passports. We can also assist you with expediting first time passport applications. You will need to complete an application form and a letter of authorization for PTDS and must send your actual passport to us. Specific requirements and the necessary forms are available for download from our Internet site: Passport Renewals First Time Passports Second Passports WWW .Traveldocs.com/PTDSPassports You may also contact us at [email protected] or 888-838-4867 and we will send you an instruction kit.

KINGDOM OF CAMBODIA Nation Religion King E ~ ~G  VISA APPLICATION FORM

PLEASE STAPLE ONE (1) PHOTO HERE

ROYAL EMBASSY OF CAMBODIA IN : Washington D.C.

Photograph 4x6

Please submit 1 copy with 1 photo and your passport Surname:

Present occupation:

DOE

First name: Jonathan Bonham ✔ Female Ŀ Sex: Male Ŀ MAR 1961 13 Date of birth: Day..…..Month………Year…...... Los Angeles CA USA Place of birth: …………………………………… Birth nationality: USA Present nationality: USA Passport of traveling document is valid for (country) ALL COUNTRIES PER YOUR ITIN Date of entry to Cambodia: Day.….Month……Year……. Date of departure (length of stay)

Engineer

Place of residence: 1234 Main Street Anywhere CA 98765

Fax: /Phone:

987-654-3210 No Fax Work Place: ABC International, Inc.

Ŀ Diplomatic Ŀ Official ĿOthers (Please Specify)

Purpose of visit ✔ Tourist Ŀ ĿBusiness

PER YOUR ITIN

Point of entry: Siem Reap Means of Transportation: Air Address during the visit: Grand Hotel D'Angkor

Point of exit: Phnom Penh Means of Transportation: Air Organization, Persons to be visited : KAMSAB - Tourist Services Provider First trip to Cambodia Ŀ✔ Yes

Grand Hotel D'Angkor

Passport No: 0123456789 Place of issue: National Passport Center Date of issue: 10 MAY 2010 Date of Expiration: 09 MAY 2020 Surname Children under 12 years traveling with you

NONE

Relatives in the Kingdom of Cambodia

NONE

For official use

éf¶pþl; …………........... Tidæakarelx ……………… elxsMKal;……………… RbePT ………………… éf¶ …… Ex …… qñaM …… htßelxam®nþITTYlbnÞúkkic©karkugs‘ul SILVERSEA CAMBODIA

Ŀ No Ŀ✔ Yes Ŀ No

Traveling on group tour First name Patronymic

Sex

M

F

Date of birth

Permanent Address

I hereby declare that the information on this form is true and correct Place, (Date)………..…………….

(Signature of the applicant)

PLEASE DO NOT FORGET TO DATE AND SIGN YOUR VISA APPLICATION

KINGDOM OF CAMBODIA Nation Religion King E ~ ~G  VISA APPLICATION FORM

Photograph 4x6

ROYAL EMBASSY OF CAMBODIA IN : Washington D.C.

Please submit 1 copy with 1 photo and your passport Surname:

Present occupation:

First name:

Place of residence:

Sex: Male Ŀ Female Ŀ Date of birth: Day..…..Month………Year…...... Place of birth: …………………………………… Birth nationality: Present nationality: Passport of traveling document is valid for (country) 2010 Date of entry to Cambodia: Day.….Month……Year……. Date of departure (length of stay)

Point of entry: Siem Reap Means of Transportation: Air Address during the visit: Grand Hotel D'Angkor Grand Hotel D'Angkor

Passport No: Place of issue: Date of issue: Date of Expiration:

Fax: /Phone:

Work Place:

Ŀ Diplomatic Ŀ Official ĿOthers (Please Specify)

Purpose of visit ✔ Tourist Ŀ ĿBusiness

Point of exit: Phnom Penh Means of Transportation: Air Organization, Persons to be visited : KAMSAB - Tourist Services Provider First trip to Cambodia Ŀ Yes

Ŀ No Ŀ✔ Yes Ŀ No

Traveling on group tour

Surname

First name Patronymic

Sex

M

F

Date of birth

Permanent Address

Children under 12 years traveling with you

Relatives in the Kingdom of Cambodia For official use

éf¶pþl; …………........... Tidæakarelx ……………… elxsMKal;……………… RbePT ………………… éf¶ …… Ex …… qñaM …… htßelxam®nþITTYlbnÞúkkic©karkugs‘ul SILVERSEA CAMBODIA

I hereby declare that the information on this form is true and correct Place, (Date)………..…………….

(Signature of the applicant)