Surname (As in Passport) Given Name (As in Passport) 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 Detai l s Passport No. Date of issue ( dd/mm/yyyy ) Place of issue Date of expiry (dd/mm/yyyy) Any other Passport/Identi ty Certi fi cate hel d (i f yes ,pl ease fi ll i n the foll owing) Country of issue Place of issue Passport/IC No Date of issue(dd/mm/yyyy) Nationality/status C. Appl icant s Contact Detail s Phone No Mobile /Cell No
Present address
Email address
Permanent Address
D. Famil y Detail s
Rel ati on Name Nati onali ty Prev. Nat ional ity Pl ace/Country of Birth Fathers Mothers Spouse Were your Grandfather/Grandmother(Paternal/Maternal ) Paki stan Nati onals Or bel ong to Paki stan hel d area : E. Detail s of Vi sa Sought (Visa shall be valid from the Date of Issue and not from the Date of J ourney) Type Of Visa Required No of Entries Period of Visa Expected Date of J ourney Port Of Arrival Port of Exit
Paste your unsigned recent color photograph. Size: 2 X 2
Signature GBRL32415913 MARZENA ANDRULEWICZ LONDON POLAND POLAND W e b
F i l e
N u m b e r
: G B R L 3 2 4 1 5 9 1 3 KALETNIK MARZENA POLAND 07888855231 W e b
R e g i s t r a t i o n
D a t e
:
3 0 - O C T - 2 0 1 3 DELHI 14-SEP-2004 14-SEP-2014 marzenaandrulewicz@gazeta.pl 24 Month ANDRULEWICZ London WC2B 4NA BY BIRTH NA SUWALKI ORLINEK POLAND DELHI 7 BYWOOD TERRACE BYWOOD AVENUE CROYDON 12-FEB-1974 POLAND India House, Aldwych Multiple HENRYK Female AJA992713 POLAND AK5590021 Un-Married NO http://www.hcilondon.in/ NO (Month) CECYLIA High Commission of India 23-NOV-2013 BUSINESS VISA GRADUATE BYWOOD AVENUE CHRISTIAN 7 BYWOOD TERRACE CROYDON, UNITED KINGDOM CR07RA Required Detail of
Purpose of Visit : F. Previ ous Vi si t Detail s Have You Ever visited India ? Address where You stayed in India
Cities in India Visited Type of Visa Visa Number Visa Issued Place Date of Issue Countries visited in last 10 years Have you been refused an Indian Visa or extension of the same previously or deported from India ? If yes above mention when and by whom with control No/Date
G. Professi on/Occupati on Detail s Present Occupation Designation/Rank Employer name/business Employer Address Phone Number
Past occupation if any Are/have you worked with Armed forces/ Police/ Para Military forces ? Organization Designation Place of Posting Rank H. Address of Place of Stay / Hotel Place/Hotel Name Address of Place / Hotel State Phone No.
I. Detail s of Two Reference In Indi a In Name Address Phone Number
J . DECLARATION:
a. I do not hold any other passport(s) other than those detailed above. b. I have read and understood all the conditions for the visit to India and I am willing and able to abide fully by them. c. I declare that the information given in the form is complete and correct and the visit to India will be undertaken for the purpose indicated in the application. d. I understand that in case the information provided in the form is found to be incorrect, I will be liable for denial of visit/ entry or deportation and/ or other penalties during the visit as provided by Indian law.
.. Date :. Applicants signature (as in Passport) JANATHULSTON NO UNITED KINGDOM FRANCE , POLAND, CYPRUS W e b
F i l e
N u m b e r
: G B R L 3 2 4 1 5 9 1 3 THE ROYAL BANK OF SCOTLAND WORKER 1 HARDMAN BOULEVARD 30-OCT-2013 01617555919 5ST GEORGE STREET,WIMBLEDON,SW19 4WL OLYMPIA TECHNOLOGY PARK ,GUINDY, CH MANCHESTER, M3 3AQ , SELALAKSHIMIALAGAPPAN 91-9840059443 Email Address Phone Company Name 0208 971 0692 NO BUSINESS BRS BUSINESS SERVICES PRIVATE LTD OLYMPIA TECHNOLOGYPARK,GUINDY, CHENNAI 91-9840059443 BUSINESS VISA
(Routledge Research in Higher Education) Jenny L. Small - Critical Religious Pluralism in Higher Education - A Social Justice Framework To Support Religious Diversity-Routledge (2020)