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EMBASSY OF INDIA, DOHA (QATAR)

Visa Application Form for Bangladeshi Nationals

(Other than Diplomatic / Official)


                     ( TO BE COMPLETED BY THE APPLICANT )

VISA NON-EXTENDABLE

1. Full name (BLOCK LETTERS) Mr. / Mrs. / Miss.

2. Place of birth:

3. Educational qualifications:

4. Occupation:

5. Nationality:

6. a) Permanent Address :
 

(b) Present Address:
 

(c) Telephone(Res.)
Mobile:
7. Name, address and nationality of Father / Spouse :
 


8. (i) Whether the following migrated to areas now constituting Bangladesh on or after 1.3.1947
    ( Applicable or Not Applicable )
(a) Applicant:
(b) Applicant's Father / Spouse  
(c) Approximate date of migration:  
(d) Address in India before migration:

9. Children accompanying the applicant, if any:
SI.No Name Sex (M/F) Date Place of Birth
1.
 
 Pick a date
2.
 
 Pick a date
3.
 
 Pick a date

10. Particulars of passport:
(a) Passport No :
    Date of Birth : Pick a date 
    Placeof Birth :
(b) Date of expiry : Pick a date   
(c) If possessing international Passport:
(d) whether it has been endorsed valid for India :

11. Whether previously in India and if so, place of residence with date:  
Date of visit:   Pick a date
Address:

12. Whether permission to visit India or to extend stay in India has been refused previously, Yes No. :
and if so, when and by whom ?
13. (i) Purpose for which visa required now :
    (ii) Period for which visa required:
    (iii) Proposed date of departure: Pick a date
    (iv) Proposed date of return : Pick a date
14. If traveling by land route, specify the Indian checkpost through which     entry and exit desired:
15. Places / Persons proposed to be visited with full address :
Name of the persons / places:
Address in full :
Telephone no. : Mobile:  
16. Whether transit visa / short-term single entry   / long-term multiple entry visa  required:(YES/NO)
17. For Transit visa only ( Applicable   or Not Applicable )
(i) Country of final destination:
(ii) (a) Is passport valid for that country ?
(b) Has visa / immigration permit of that country been obtained ?
18. For Student only ( Applicable   or Not Applicable )

Name and address of the institution in India in which admission has been secured (attach attested copy of admission certificate or other relevant document)
Name :  
Address:  
          
19. Names, addresses and contact numbers of two persons in India and in Bangladesh to whom applicant is well known:
In India :  
1.Name  
Address :  
Contact number :  
   
2.Name  
Address :  
Contact number :  
   
In Bangladesh :  
1.Name  
Address :  
Contact number :  
   
2.Name  
Address :  
Contact number :  
20. How are the expenses proposed to be met for stay in India:  
  (State foreign exchange authorized) 
21. If not carrying foreign exchange, furnish:Sponsorship certificate in prescribed form  
   
22. (i) Do you belong / have you previously belonged to military / semi-military, Police / semi-police organization? : ( YES / NO )
(ii) If the answer is YES, please give details:  
I enclose copies of this application along with copies of my recent photograph.


I hereby certify that the information furnished above is correct and further undertake that I shall utilize my visit to India for purpose for which the visa has been applied for and shall not on arrival in India, try to obtain employment or set up business or to extend my stay for any other purpose.



Date : Pick a date 
P.O. Box No.
Tel No. (Office)      
(Residence)
(Mobile)

(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