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 :

(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 :

(DD-MM-YYYY)

8.(c) Issued By :

8.(d) Place of Issue :

8.(e) Expiring on :

(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   (DD - MM - YYYY ) MALEFEMALE   (DD - MM - YYYY ) MALEFEMALE   (DD - MM - YYYY ) MALEFEMALE   (DD - MM - YYYY ) MALEFEMALE   (DD - MM - YYYY ) MALEFEMALE   (DD - MM - YYYY ) MALEFEMALE

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 :

(DD-MM-YYYY)

16.(b) Approximate Date of Departure from India :

(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 :

(DD-MM-YYYY)