High Commission of India: Visa Application Form
High Commission of India: Visa Application Form
High Commission of India: Visa Application Form
Signature
BGDDV2889918
Nationality/status
Gulshan
C. Applicant’s Contact Details
D. Family Details
Relation Name Nationality Prev. Nationality Place/Country of Birth
MANIKGANJ
Father’s MONIRUL HAQUE BANGLADESH BANGLADESH BANGLADESH
MANIKGANJ
Mother’s ANJU MONOARA BEGUM BANGLADESH BANGLADESH BANGLADESH
Spouse
IMRANUL HAQUE
Required Detail of TOURIST VISA
Places to be Visited KOLKATA
Application Id :BGDDV2889918
Cities in India Visited
Type of Visa Visa Number
Visa Issued Place Date of Issue
Countries visited in last 10 years
Have you been refused an Indian Visa or extension of the same previously or deported from India ?
If yes above mention when and by whom with control
No/Date
G. Profession/Occupation Details of Father
Present Occupation STUDENT Designation/Rank OFFICE ASSISTANT
Employer name/business M A ROUF DEGREE COLLEGE
Employer Address MANIKGONJ, JHITKA, KOWRY
Phone Number
+8801710273723
Past occupation if any
Are/have you worked with Armed forces/ Police/ Para Military forces ? NO
Organization Designation
Place of Posting Rank
H. Address of Place of Stay / Hotel
Place/Hotel Name Address of Place / Hotel State Phone No.
1 HOTEL ORIENTAL 9A, MARQUIS STREET KOLKATA WEST BENGAL. +91 33 2252 993,
2 .,
3 .,
4 .,
I. Details of Two Reference
In India In BANGLADESH
Name HOTEL ORIENTAL ARIFUL HAQUE
Address 9A, MARQUIS STREET SAOUT SHEWTA, W-01
KOLKATA, WEST BENGAL MANIKGANJ SADAR, MANIKGANJ
Phone
+91 33 2252 993 01710273723
Number
J. DECLARATION:
a. I do not hold any other passport(s) other than those detailed above.
b. I have read and understood all the conditions for the visit to India and I am willing and able to abide fully by them.
c. I declare that the information given in the form is complete and correct and the visit to India will be undertaken for the
purpose indicated in the application.
d. I understand that in case the information provided in the form is found to be incorrect, I will be liable for denial of visit/ entry
or deportation and/ or other penalties during the visit as provided by Indian law.
..……………………………………
23-JAN-2018
Date :………………………. Applicant’s signature (as in Passport)