Please Affix

a passport
size photo
here

Application for approval of research project and for

authorization of visa (to be submitted in 6 sets)

PART – A

1. NAME:
Surname First name Middle name

2. Father’s name:
(Husband’s name in case of marries women )
3. Sex:
4. Date of birth:
5. (a) Nationality:

(b) Passport No. & date of issue and period of validity:

Passport Number Date of issue Place of issue Date of Expiry Period of validity

6. (a) Occupation
(status and Institution):

(b) Present Address:

(c) Permanent address:

7. Accompanying dependents/spouse
(Name, Sex, Nationality & place & date of issue & period of its validity & ocupation to be given)

Name Sex Nationality Pass. No. Place of Iss. Date of Iss. Date of Expiry Occp.

8. Major field of specialization:

9. Source of funding:
a) Details of Funding agency/agencies:
 b) Is self financed, supporting documentary
evidence e.g. Bank statement for the last
6 months, salary slip if employed may be
Furnished:

10. Proposed duration of stay in India:

11. Academic training:

Colleges/University Year Degree Major field attended

Earned

12. Professional employment history (Beginning with most resent):

Inclusive date Position Institution

13. Publications:

14. Proficiency in Indian Languages:

15. Whether the scholar applied for or

undertook any other project in India
in past and if so, the details thereof.
Please also indicate whether the present
project is in continuation extension of
the earlier project or a separate project:

16.
a) Whether the scholar has applied earlier
for research visa in India or to any other
country, if yes name of the country/institution:

b) If so, whether the applicant has been rejected

by that country/institution

c) In case of rejection, the reasons thereof:

17. Previous visits and stay to India and to other countries during the last 10 years::

Date of visit Places visited Purpose Category of visa/Duration of stay

Part – B

18. Title of proposed research

project in India:

19. Name of Indian Institution

University of affiliation
be undertaken and name of Indian
project supervisor/consultant.
(Certificate of affiliation from
the Institutions/University
should be enclosed.

20. Major objectives of investigation;

(precise information should be
given here & the research project
giving the information in detail,
may be enclosed)

21. Problem to be investigated:

22. Places to be visited:

23. Research methodology:

24. Type of data to be collected:

and sources from which it is
to be gathered:

25. Whether the project will be

undertaken individually or
some other foreign scholar/
Indian scholar will also work.
If so, give details (Including
Bio-data of the other scholar(s)
And also a full program):

26. Name of Indian mission where

visa authorization is to be sent:

Note: Concealment of any material/information or any Misstatement is likely to

result in the refection of the Application.
 UNDERTAKING

In connection with grant of research visa to me for undertaking Ph.D. student in India, I undertake
that while in India I will not engage in political activities, activities prejudicial to the interests of India
or activities, which could be embarrassing to Indian’s relation with any foreign country.

I also undertake that the entire expenditure on the research project in India will be met by foreign
exchange remitted through normal banking channels.

I also understand that I am not to visit any border / restricted /protected/ prohibited/tribal areas in
India in connection with the research project.

(SIGNATURE OF APPLICANT)
 Itinerary

I, , an Iranian national holding Iranian

passport No. issued at on ,
hereby apply for research visa to pursue my Ph.D. in

in the Department of at

In the event of approval of my research visa, I undertake that I will not visit any
other city in India except for the city of my admission i.e.

Thank you very much.

Yours faithfully,
 CERTIFICATE OF AFFILIATION

This is to certify that Mr./Mrs./Miss_________________________________________________

(Name in Block letters)

nationality___________________________________________ at present studying/ working at

_____________________________________________________________________________
_
(Name of the University/Organization in the Country of Residence)

shall be affiliated as a student/research worker in the department of _______________________

_________________________________________of this University for undertaking research on

_____________________________________________________________________________
_
(Title of the project)

He/She shall be assisted/guided by _________________________________________________

(Name of Indian research guide)

of the Department of ____________________________________________________________.

This affiliation does not involve any financial liability to the part of university and is subject to
the approval of the above mentioned research project by the Government of India.

Date: ____________________ _________________________________________

(Signature & Official Seal of Certifying Authority)

Note: The certificate should be signed and stamped by the head of institution/Vice-Chancellor or
Registrar of the University agreeing to affiliate the foreign scholar.