ats Student Residence Visa Application Form (Fillin capita letters as per passport. Incomplete application form wihhoutmandatory documents fs not acceptable) 4. Student Particulars: Name of the Student Application / Institute ID No Date of Birth Passport Number Nationality Contact Telephone Nos. UAE Native Country Email ID Residential Status 2. Parent / Guardian Contact Detail Parent / Guardian Name Contact Telephone Nos. UAE Native Country Email ID + _DEVANSH MITTAL 5 2022)6POC/FINNNG ? 06/10/2003 Gender 7M fey FL] £ W456 05192 Date of Expiry : |} (03/2032 LINDT AN_ Religion i HENDU 2 H) 4009 684 254 : DEVANSH* MITTAL 03@ GMAT L- Lom :Day Scholar] BPDC Hostler fe + _DEEPAK KumAk MITTAL 2Ce)) 740400 1679 2 DAM 14 EN @ YAH CD +Gom Enclosures" 41. Duly filed Dubai Technology and Media Free Zone Authority (OTMFZA) Student Undertaking Form 2. Clear photo copy of the passport with the validity period of 7 months. 3. _Passpor Size Photo soft copy strictly as per the aiven link ftom the studio (not a scanned image) 4. Clear photo copy of the Undergraduate / equivalent cenificate (higher degree programme student oniy) 5. Valid Heaith insurance Card acceptable in UAE (or) Medical insurance fee receipt 6._ Emirates ID Card Copy (if applicable) — the student had been in UAE eavlior with UAE residence visa * Submission of colour scanned copy of all the above documents (in jpeg format) is mandatory by email to bigher DngreeProwramme cudonts are requis to submit ateted UG Crit bythe UAE Embessy th | have read, understood and accept the terms and conditions of the student residence visa and request for student residence visa facilitated by BITS Pilani, Dubai Campus. Tam enclosing all the documents mentioned above and also agree to abide by the rules and regulations set by the institute, DDA, DIAC, DNRD and Gov, of U.A.E Dovanth Mittal Signature of Student For Office Use Forwarded to Admin Dept. for Visa Process In-charge - Admissions Dept. Date: Date 14/12] 202.2. Approved for Visa Process In-charge - Administration Dept. Date:40. 1 2, 18. 14. 15, 16 7, 18 19 20, Itis mendatory forall students to have a valid UAE. residence visa to study at BITS Pilani, Dubai Campus (BPDC). Ifthe parent or guardian cannot sponsor the student or ifthe student is a non-resident of UAE, then the BPDC can facilitate UAE. Student Residence Visa (visa) under the sponsorship of Dubai Development Authority (DA) through Dubai Intexnatonal Academic City (DIAC) subject io the submission and approval of necessary document given in the student tesidence visa application fom (visa form), rules & regulations of BPDC and Government of UAE (Govt). AS a facilitator, BPDC only co-ordnates betweon DDA and students for obtaining the visa. ‘The visa is valid for one year and is subsequently renowable every year, The issue of fresh visa and renewal of visa are Subject to the submission of necessary documents and as per rules and regulations of BPDC, ODA, DIAC, General Directorate of Residency and Foreign Afairs Dubai (GORFAD), Ministry of Health (MOH) and Gov. BPDC is not responsible for any delay or non issuance of new visa or rejection of visa renewal by the Govt. ‘The rules & regulations regarding conditions for visa issuance of GDRFAD, MOH and Govt may change from time to time. ‘The mandatory documents as mentoned in the wsa form should be submitted on or before the scheduled date by the BPO ‘Admissicns Depariment and/or BPDC Administration (Admin Dept). For visa renewal elther the student should submit the necessary dacuments on or before the scheduled date by the Admin Deptor atieast 8 weeks before the actual isa expiry date stamped inthe passport ‘Submission of invalid documents oF non submission of required documents or late submission of required documents, or delaying the visa medical andior related formalities beyond the scheduled date by DHA./ National Emirates 1D Authority (IDA) /Instiute will lead to immigration fines and penalty, The student & responsible forsuch fines and penalty. Valid health insurance % mandatory. Students ate required to undergo a medical examination as prescribed by MOH / GORFAD in the specified Gout. hospitals afer their arval in UAE to stamp the muliple entry visa in theit passport. The medical examination and the ‘elated process usually take 3 — 5 weeks. I any student 6 declared medically unfit by MOHIGDRFAD, hisier residence visa will not be stamped / renewed and the student should leave the country immediately after canceling the isa, ier the visa stamping in the passport, student can travel outside UAE any number of tines wih the prior approval of BPOC. Student should not stay outside UAE for more than 180 days continuously after the visa is Stamped on the passport. ifthe student stays beyond 180 days, his visa becomes invalid and will nat ne allowed to enter UAE Visa facilitated by BPDC is for the purpose of education only and students are not permitted to work. ‘Student should contactthe Admin Deptat least a month belore the visa expiryfor the visa renewal. Student should pay Dhs.2,900/" for fresh visa & related sence fee. The amount paid towards fresh visa & related service fee is non-retindable. In case of students, who are a resident of [Link]. on their own visa sponsorship and wish to come under the visa faditated by the institute by in-country & local amendment should pay a sum of OAs. 4.700) towards fresh visa and related sence: ‘charges. in such case, the student is required to submit the orginal passport and visa cancellation paper immediately ater ‘he cancellation of ne existing visa along with al other required documents to process the student usa, Students should pay sum of Dhs.2,150/ per year towards sa renewal and related service charges. ‘The visa and relatod sonices foe inchdes Dhs 280/- towards mandatory EIDA Card issued by Govt ‘The visa renewal and related senice charges should be paid before applying for subsequent year visa renewal ‘The visa cancelation can be done only inside UAE by DOA through BPC. Alter completion ofthe program andlor before leaving the Insitute, the student residence vsa muste cancolled by the BPDC Admin Dept mespecive ofthe sa validity stamped inthe passport ofthe student. Hence student must complete the necessary formalites including submission of the ‘original passport EIDA card and payment of cancelation fees. The cancellation ee is AED 1850/- out of which AED 1000/- is towards visa deposit, which wil be refunded. The nomal tine frame for cancollation is 10 to 15 working daye. Students ‘who have stayed outside UAE for more than 180 days continuously are also required to cancel thelr isa through Admin Dept even though tho visa is invalid. Failure to do $0 wil resuit in serious consequences as pet rules and regulations of Institute, DDA, GORFAD and Gow. Student should keep themselves updated about the rules and regulations pertaining o the terms and conditions of their residence visa as stipulated by GORFAD. ‘Student should abide by all he rules and regulation of the BPDC, DDA, GDREAD and Govt. Non-compliance of any laws ‘and requlation by various Autnorives may lead to penalty including deportation for which BPO is not responsible Cancellation of Enty permit wil take a minimum of 10 0 15 working days, {All the feo chargesas mentioned above for visa& related [Link] indicative only and or subject to change &s per ‘ules and regulations of the institute, DDA, DIAC, GDRFAD and Govt With regardsto EIDA 1og on to The student should noiity any changes in the information given inthe vise formand/or passport to the Admin Dept Had Signature of the Student oe ineStudent Undertaking: 1, By accepting the offer of enrolment. The Student hereby covenants the following: (While enrolled in the Institution and under the Student Visa sponsorship of DTMFZA. The Student shall not hold employment in the United Arab Emirates: (ii) The Student undertakes to abide by DTMFZA Health and Safety Environment Regulation, and that any or all rules may be altered or added to at any time by DIMFZA and the Student undertakes to support these regulations; (iii) The Student undertakes to obtain and maintain an appropriate health insurance while enrolled and holding the Student visa sponsorship of DTMFZA: (iv) The Student hereby further undertakes to abide by the Dubai International Academic City Shared Facility Guidelines and or any other policy which may be implemented by DIAC time to time: (v) The Student acknowled ges he/she is primarily responsible for hipster conduct. attitudes and general education while he is enrolled within the Free Zone: (vi) The Student shall indemnify and keep indemnified DTMFZA against any and all actions, claims. liabilities, losses, damages, costs or expenses of any nature whatsoever (including legal {ees incurred in connection therewith) in relation to any action by the Institution or Students or by any third parties and against all losses or damage to any property (including any property of the Free Zone) which may are in consequence of the performance or non performance of the Student Sponsorship Agreement or otherwise under these terms and conditions: (vii) The Student agrees that DTMFZA is authorized to initiate whatever reasonable disciplinary measures DTMFZA deems necessary in relation to the conduct of the Student as a result of any act. Omission or behavior, judged to be sufficiently serious, or to terminate the Student visa without notice. This will apply to behavior on campus. And anywhere else where the Student's behavior reflects adversely on DIMFZA; (viii) To abide by the rules, policies, guidelines and regulations as may be implemented by DTMFA from time to time including any amendments thereof: (ix) The Student hereby acknowledge and undertake that in the event of any breach or failure to comply with the above mentioned undertakings including but not limited to any breach of DTMFZA rules, policies, guidelines and regulations. DTMFZA shall have all the right to revoke. Cancel and to terminate the Student Sponsorship without any further notice, 2. The Student hereby voluntarily executes this Undertaking upon his free will and accord and acknowledges that he/she have read and understood the contents therewith, Dwanth Mito Signed by: Name: DEVANSH MITTAL Nationality: 2M 9 T AN Passport No: w'4 50 5 192.