INFORMATION MUST FILLED BY APPLICANT AND SPOUSE (IF ANY) INDIVIDUALLY

DO YOU HOLD/HAD USA VISA EARLIER…IF YES THEN PLEASE ATTACH THE COPY OF THE SAME HEREWITH

FULL NAME
DOB & Place of Birth
ADDRESS
CONTACT NUMBER(S)
EMAIL ID
HEIGHT
COLOR OF EYES
COLOR OF HAIR
PASSPORT NUMBER
PASSPORT ISSUE DATE
PASSPORT EXPIRY DATE
PASSPORT ISSUING
AUTHORITY
DRIVING LICENSE
NUMBER
PAN CARD NUMBER
MARITAL STATUS
MARRIAGE DATE

EDUCATION
(MUST PUT DATE, MONTH AND YEAR)
FROM TO(DATE/MONTH NAME OF INSTITUTE / DEGREE/DIPLOMA/BOARD
(DATE/MONTH & YEAR) UNIVERSITY
& YEAR)
EMPLOYMENT

NAME OF EMPLOYER 1.
ADDRESS & CONTACT
NO.

JOB DESIGNATION

JOINING DATE

RELEIVING DATE

MONTLY SALARY

ADDRESS OF EMPLOYER

CONTACT NO. OF EMP.

JOB DESCRIPTION

.
 LIST OF PLACES WHERE YOU LIVE IN LAST 10 YEARS

FROM TO(MONTH & ADDRESS

(MONTH & YEAR)
YEAR)

Fill Family detail as below:

Please provide us with FULL list of ALL your family members (parents, brothers, sisters, spouse and children including deceased or
adopted members)

Nationality

Full Name Date of Relationship to you Country of Passport Date of expiry

birth & Birth Number of passport
Place of
birth
FATHER

MOTHER

SPOUSE

BROTHER-1

BROTHER-2

SISTER-1

SISTER-2

CHILD-1
 CHILD-2

 Contact Numbers & email id (If any) of yourself & family members.
Self:
Spouse:
Parents:
Sponsor 1:
Sponsor 2:
Sponsor 3:
Sponsor 4:

References (from home town/ Gujarat/ India) Detail (Kindly put two references detail who knows you
very well)

Name of references Contact number & Address

email ID

Relative (from the USA) Detail

Name of Relative & Contact number & Address

your relation with email ID
him/her
 Previous Refusals

Country Type of visa applied & Reason of refusal

on which date

Details of parents

FULL NAME Contact number Address Date of birth & place of birth
& email ID

FATHER

MOTHER

Details of Children (if you wish to add in your application)

FULL NAME School address & current study (in which Grade) Date of birth & place of birth

Child 1

Child 2
Details of Spouse

FULL NAME Date of birth & FULL ADDRESS

place of birth

Details of University/College which you are going to pursue...

 Name of University/College

 Intake

 Course name

 Start date/month/year

 End date/month/year

 College’s email ID and contact number

 College’s contact person’s name

Details of your personal life...

 Your Face book , Instagram account’s ID