India E-Visa Application Getting Ready Checklist TO COMPLETE THIS APPLICATION FORM, YOU WILL NEED: Passport It must be valid for at least 6 months after your intended departure date and must contain at least 2 consecutive blank pages. Place of Accommodation Your hotel information or invitation letter from your host Intended Travel Dates This information may change, but you should complete this application with your planned/estimated dates for now. APPLICANT DETAILS Given Name (as in Passport) Surname (as in Passport) Date of Birth Gender Male Female Marital Status Married Spouse’s Full Name Spouse’s City of Birth Spouse’s Country of Birth Spouse’s Nationality/Citizenship Spouse’s Previous Citizenship/Nationality at Birth Has your spouse ever held any other Nationality/Citizenship? Yes No If Yes, please provide country and passport numbers. Single Widowed Divorced Separated Spouse’s Full Name Spouse’s City of Birth Spouse’s Country of Birth Spouse’s Nationality/Citizenship Spouse’s Previous Citizenship/Nationality at Birth Has your spouse ever held any other Nationality/Citizenship? Yes No If Yes, please provide country and passport numbers. Other Are you known by any other names or aliases? No Yes, Please provide any previously used names City of Birth Country of Birth Current Citizenship (as indicated in Passport) Do you hold any other Citizenship? (If yes, Indicate which other citizenship) Did you acquire present nationality by birth or by naturalization? By Birth Naturalization, Previous nationality Do you currently hold any other valid passport or identity document (ie. US Permanent Resident card)? No Yes Country of Issuance Passport Number Date of issuance (M/D/Y) Place of Issuance Nationality (as listed on the document) Religion Bahai Buddhism Christian Hindu Islam Parsi Sikh Zoroastrian Other, Specify Highest educational qualification Minor No formal education Less than 10th grade 10th Grade or higher High school graduate or equivalent Professional/technical certification Undergraduate degree Post graduate degree www.apvi.com Page 1 India E-Visa Application PASSPORT / TRAVEL DOCUMENT Passport Number Place of Issue/Issuing Authority Passport Date of Issue Passport Expiration Date WORK/SCHOOL INFORMATION (IF APPLICABLE) Street Name & Number City State Zip Country Name of Current Employer/School Position (Occupation) Phone Number FAMILY DETAILS Mother’s full name Mother’s City of Birth Mother’s Country of Birth Mother’s Nationality/Citizenship Mother’s Previous Nationality/Citizenship at Birth Father’s Full Name Father’s City of Birth Father’s Country of Birth Father’s Nationality/Citizenship Father’s Previous Nationality/Citizenship at Birth Father ‘s Occupation Father’s Employer Father’s Employer Address Father’s Work Phone Number Have you, your parents, or your grandparents ever held the nationality of Pakistan? No Yes, Unfortunately at this time we cannot assist applicants of Pakistani origin. You need to apply in person at the nearest Indian Consulate. TRIP DETAILS Type of E-Visa Dates of Travel to India (Entry & Exit) Previous Citizenship/Nationality at Birth Purpose of Visit Cities you Intend to Visit Recreation/Sight Seeing Meeting Friends/Relatives Short Term Yoga Program Name of Institute in India Address Phone Traveling By Air Sea Ground E-visas are only eligible for entry at the following seaports: E-Visas are only eligible for entry at a limited number of airports Cochin, Goa, Mangalore, Mumbai, Chennai. For all other seaports and seaports. For entry by ground, please follow the regular visa of entry, please select the regular tourist visa. procedure. Has your request for an India visa or extension of stay in India ever been refused? No Yes, Please include Date (month/day/year) & Control number Have you visited South Asian Association for Regional Cooperation (SAARC) countries (except your own country) during the last 3 years? SAARC countries Include: Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, Sri Lanka. No Yes, Specify country and Year of Visit & Number of Visits List all countries you have visited during the past 10 years www.apvi.com Page 2 India E-Visa Application Port of Arrival in India Departure Port from India Ahmedabad Airport Hyderabad Airport Ahmedabad Airport Hyderabad Airport Amritsar Airport Jaipur Airport Amritsar Airport Jaipur Airport Bagdogra Airport Kolkata Airport Bagdogra Airport Kolkata Airport Bengaluru Airport Lucknow Airport Bengaluru Airport Lucknow Airport Calicut Airport Mangalore Airport Calicut Airport Mangalore Airport Chandigarh Airport Mangalore Seaport Chandigarh Airport Mangalore Seaport Chennai Airport Mumbai Airport Chennai Airport Mumbai Airport Chennai Seaport Mumbai Seaport Chennai Seaport Mumbai Seaport Cochin Airport Nagpur Airport Cochin Airport Nagpur Airport Cochin Seaport Pune Airport Cochin Seaport Pune Airport Coimbatore Airport Tiruchirappalli Airport Coimbatore Airport Tiruchirappalli Airport Delhi Airport Trivandrum Airport Delhi Airport Trivandrum Airport Gaya Airport Varanasi Airport Gaya Airport Varanasi Airport Goa Airport Vishakhapatnam Airport Goa Airport Vishakhapatnam Airport Goa Seaport Other: Goa Seaport Other: Guwahati Airport Guwahati Airport REFERENCES Company NGO Government School Family Friend Full name of contact Street Address City Zip Phone number Relationship Hotel Name of Hotel (where you will be staying) Hotel Phone Number Have you visited India before? (Select “No” if you have lived in India before) No Yes Most Recent Date of Entry Most Recent Date of Departure Places Visited Accommodations Address Have you ever been issued a visa to India before? No Yes City Visa was Issued Visa Number Issue Date Visa type Business visa Entry visa Student visa Tourist visa Employment visa REFERENCE IN UNITED STATES OF AMERICA I have completed this form as accurately as possible. I realize that any typos or errors made on this form will also display on my E-Visa. I understand that an E-Visa that was Name received with errors will require a new submission and repayment of fees. Address Applicant Signature Date Zip code Phone www.apvi.com Page 3.