Visa Information
Visa information collection form
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Surname *
Given Name *
Passport Number:
*
Place of Issue:
*
Nationality:
*
Date of Birth:
*
MM
/
DD
/
YYYY
Place of Birth:
*
Date of Issue:
*
MM
/
DD
/
YYYY
Date of Expiry:
*
MM
/
DD
/
YYYY
Conference Registration Ticket No.
Indian Embassy’s complete postal address (The Embassy where you apply for your Indian visa)
*
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This form was created inside of VLSI SOCIETY OF INDIA.