私なら・・・

(日付：右隅)　xx October 2015
(タイトル：中央下線付) Tourist Visa Application
(本文) Dear sir,
I/We, (name 1) and (name 2) am/are planning to sightsee your country as per following itinerary.
(Date 1) Fly to (name of city or airport) from (name of city or airport) via (flight number) and stay at (name of hotel or equivalent)
(Date 2) Sightsee (name of city) and stay at (name of hotel or equivalent)
(Date 3) Sightsee (name of city) and stay at (name of hotel or equivalent)
(Date 4) Fly to (name of destination airport) from (name of departure airport) via (flight number)
then, your permittion is highly appreciated.
(結び：右隅)　Best regards
(自筆署名＋下線)　　○○○○
（名前）　　　（xxxx xxxx）
(自筆署名＋下線)　　◎◎◎◎
名前）　　　（yyyy yyyy）