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EMBASSY OF INDIA, DOHA (QATAR)

VISA APPILCATION FORM


Part 'A'
( TO BE FILLED IN DUPLICATE BY ALL APPLICANTS )

1.(a) Full Name :        Mr. Mrs. Miss. 

1.(b) Previous Name, if any :

2.(a) Present Nationality :

2.(b) Any other nationality :
        ( Present or Previous )


3.(a) Father's Name :
          & Nationality :

3.(b) Spouse's Name :
        ( If Not Applicable Denote 'NIL' )

4. Place of Birth :
    ( in BLOCK Letters )
City :
State / Province :
Country :


5. Date of Birth :   Pick a date (DD-MM-YYYY)

6. Address
Phone No :
Mobile No :


7. * Profession :
( Details of Present employment )
      Please indicate name of the Organization where employed along with the post held.

8.(a) Passport No :            

8.(b) Date of Issue : Pick a date (DD-MM-YYYY)

8.(c) Issued By :

8.(d) Place of Issue :

8.(e) Expiring on : Pick a date (DD-MM-YYYY)

9. Children included in the applicant's passport.
    ( To be filled only when children are accompanying the applicant )
Name Place Date of Birth Sex Relationship Identification mark, if any

  Pick a date
(DD - MM - YYYY )

  Pick a date
(DD - MM - YYYY )

  Pick a date
(DD - MM - YYYY )

  Pick a date
(DD - MM - YYYY )

  Pick a date
(DD - MM - YYYY )

  Pick a date
(DD - MM - YYYY )

10. Whether visa has been refused
      previously? If 'YES', give details
YES NO

11. Details of previous visits to India, if any :

12.(a) Period for which visa is required :

12.(b) No. of Entries : Single  Double  Triple / Multiple

13. Countries from which entry into India will be
      made :

14. Purpose of Journey : Transit  Tourist  Business  Education 
any other (specify) :

15. Place(s) in India to be visited :

16.(a) Approximate Date of Arrival in India : Pick a date (DD-MM-YYYY)

16.(b) Approximate Date of Departure from India : Pick a date (DD-MM-YYYY)

17.(a) Port of first entry into India :

17.(b) Port of final departure from India :

Part 'B'
( TO BE FILLED IN BY ALL APPLICANTS )

1. Whether holding valid "No objection to return to India"
     endorsement and if so, give particulars :
YES  NO 

2. Name, address and contact number of two references :
2.(a) Address in the country of Applicant
Name :
Address Line 1 :
Address Line 2 :
Phone/Mobile No :

2.(b) Address in the country of Applicant
Name :
Address Line 1 :
Address Line 2 :
Phone/Mobile No :
2.(c) Address in India
Name :
Address Line 1 :
Address Line 2 :
Phone/Mobile No :
2.(d) Address in India
Name :
Address Line 1 :
Address Line 2 :
Phone/Mobile No :

(TO BE FILLED IN DUPLICATE BY ALL APPLICANTS)

ADDITIONAL INFORMATION TO BE FURNISHED BY ALL THE APPLICANTS

1) Mode of acquiring the present Nationality by the Applicant :
a) By Birth  b) By naturalization  c) Any other  

2) Any other Nationality of Applicant's Father :
 ( other than the one mentioned in Part-A )

3) Name & Nationality of Applicant's Mother :
Name :  
Nationality :  

4) Any other Nationality of Applicant's Mother :
 ( present or previous )

5) Name & Nationality of Applicant's paternal Grandfather :
Name :  
Nationality :  

6) Name & Nationality of Applicant's paternal Grandmother :
Name :  
Nationality :  

7) Name & Nationality of Applicant's maternal Grandfather :
Name :  
Nationality :  

8) Name & Nationality of Applicant's maternal Grandmother :
Name :  
Nationality :  


9) Nationality of Applicant's Spouse :

10) Countries visited by the Applicant during the last 10 years :

11) The address of friends / relatives / places of stay during the previous travel to India :
  
  

12) Places from where visa was acquired during previous visits :

13) Telephone and Mobile number in India of :
Applicant :  
His / Her sponsor :  


Date : Pick a date (DD-MM-YYYY)