High Commission of India
India House, Aldwych
Please do not affix your
London WC2B 4NA
50mm x 50mm (2"x2")
passport photo here.
(Just leave in envelope)
Visa Application Form
Signature
A. Personal Particulars (As in Passport)
Surname
Name
Previous/other Name if any
Sex
Marital Status
Date of birth
Religion
Place of Birth Town/City
Country of Birth
Citizenship /National ID No
Educational Qualification
Visible identification marks
Current Nationality
Nationality by Birth/ Naturalization
Any Other Previous/Past Nationality
B. Passport Details
Passport No.
Date of issue ( dd/mm/yyyy )
Place of issue
Date of expiry (dd/mm/yyyy)
Any other Passport/Identity Certificate held (if yes ,please fill in the following)
Country of issue
Place of issue
Passport/IC No
Date of issue(dd/mm/yyyy)
Nationality/status
C. Applicant’s Contact Details
Phone No
Present
Mobile /Cell No
address
Email address
Permanent
Address
D. Family Details
Relation
Name
Nationality
Place/Country of Birth
Prev. Nationality
Father’s
Mother’s
Spouse
Were your Grandfather/Grandmother(Paternal/Maternal) Pakistan Nationals Or belong to Pakistan held area :
E. Details of Visa Sought
Type Of Visa Required
No of Entries
(Month)
Period of Visa
Expected Date of Journey
Port Of Arrival
Port of Exit