Passport Type |
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E-mail |
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Applicant Details |
Surname (as shown in your Passport) |
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Given Name/s (as shown in your Passport) |
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Have you ever changed your name? |
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Previous Surname |
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Previous Name |
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Gender |
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Date of Birth |
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Town/City of Birth |
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Country of Birth |
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Citizenship/National Id No. |
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Religion |
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Visible identification marks |
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Educational Qualification |
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Nationality |
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Did you acquire Nationality by birth or by naturalization? |
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Prev. Nationality |
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Have you lived for at least two years in the country where you are applying visa? |
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Passport Details |
Passport No. |
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Place of Issue |
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Date of Issue |
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Date of Expiry |
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Any other valid Passport/Identity Certificate(IC) held? |
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Country of Issue |
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Passport/IC No. |
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Date of Issue |
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Place of Issue |
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Nationality mentioned therein |
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Applicant's Address Details |
Present Address |
House No./Street |
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Village/Town/City |
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State/Province/District |
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Postal/Zip Code |
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Country |
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Phone No. |
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Mobile No. |
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Permanent Address ( - check if same address)
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House No./Street |
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Village/Town/City |
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State/Province/District |
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Family Details |
Father's Details |
Name |
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Nationality |
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Previous Nationality |
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Place of Birth |
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Country of Birth |
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Mother's Details |
Name |
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Nationality |
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Previous Nationality |
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Place of Birth |
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Country of Birth |
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Other Details |
Applicant's Marital Status |
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Spouse's Details |
Name |
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Nationality |
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Previous Nationality |
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Place of Birth |
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Country of Birth |
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Were your Grandfather/ Grandmother (paternal/maternal) Pakistan Nationals or Belong to Pakistan held area? |
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If Yes, give details |
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Profession / Occupation Details of Applicant |
Present Occupation |
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Employer Name/business |
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Designation |
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Address |
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Phone |
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Past Occupation, if any |
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Are/were you in a Military/Semi-Military/Police/Security Organization? |
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Organisation |
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Designation |
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Rank |
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Place of Posting |
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Details of Visa Sought |
Visa Type |
E-Visa multiple-entry valid for 365 days with max 180 days stay (5 Business Days Processing) - $150.00
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Places likely to be visited |
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Purpose of Visit |
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Expected Date of Arrival |
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Port Of Arrival in India |
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Port Of Exit from India |
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Friends/relatives details |
Full Name of Friend/Relative |
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Address |
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State |
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District |
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Phone |
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Previous Visa/Currently valid Visa Details |
Have you ever visited India before? |
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Address of stay during your last visit |
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Cities previously visited in India |
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Last Indian Visa No/Currently valid Indian Visa No. |
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Type of Visa |
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Place of Issue |
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Date of Issue |
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Has permission to visit or to extend stay in India previously been refused? |
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If so, when and by whom (Mention Control No. and date also) |
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Other Information |
Countries Visited in Last 10 years |
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SAARC Country Visit Details |
Have you visited "South Asian Association for Regional Cooperation" (SAARC) countries (except your own country) during last 3 years? |
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Reference |
Reference Name in India |
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Address |
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Phone |
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Reference Name in Home Country |
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Address |
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Phone |
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Upload |
Upload your photo (pdf, jpg, , jpeg, png, 350KB max) |
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Photo page of Passport containing personal details like name,date of birth,
nationality , expiry date etc. to be uploaded by the applicant. (pdf, jpg, , jpeg, png, 350KB max) |
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Upload scanned copy of the letter from the Hospital concerned in India on its letterhead (pdf, jpg, , jpeg, png, 350KB max) |
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Upload scanned copy of applicant's business card
(pdf, jpg, , jpeg, png, 350KB max) |
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Invitation of the host institute to the foreign faculty
(pdf, jpg, , jpeg, png, 350KB max) |
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Copy of the sanction order under GIAN issued by National Coordinating Institute viz. IIT Kharagpur
(pdf, jpg, , jpeg, png, 350KB max) |
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Copy of the synopsis of the courses to be taken up by the faculty
(pdf, jpg, , jpeg, png, 350KB max) |
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PLEASE NOTE:
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Photo page of Passport uploaded should be of the same passport whose details are provided in
Passport Details section.
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The application is liable to be rejected if the uploaded document is not clear and as per
specification.
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I have verified that the uploaded passport copy has the same details as mentioned in the passport details section.
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I agree to these Terms and Conditions of e-visa services by Visa Center.
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