TRAVCOUR (UK) LTD ORDER FORM

Falcon House, Suite 2, 19 Deer Park Road, Wimbledon, SW19 3UX

Tel: 020 85431846

e-mail: info@travcour.com Website: www.travcour.com

Open Hours: (Mon – Fri) 9.00am to 5.00pm

TRAVCOUR VISA ORDER FORM (PLEASE COMPLETE ALL SECTIONS IN BLOCK CAPITALS)

(THIS FORM CAN BE TYPED OR COMPLETED MANUALLY. THIS FORM IS NOT A VISA APPLICATION FORM)

STEP 1: PLEASE CONFIRM YOUR CONTACT DETAILS AND RETURN ADDRESS. We will only correspond with the person detailed on this form regarding your application. The order form must be supplied once per party whilst the application is required per person.

TITLE: MR. MRS. MISS. DR.

SURNAME:

COUNTRY:

CHARGE

Royal Mail Special Delivery 9.00 Only applicable for UK residents. For terms & conditions please visit www.royalmail.com

40.00

P.O.A

FREE

FREE

Email FREE

CHEQUE/POSTAL ORDER (Payable to Travcour (UK) LTD)

DEBIT CARD (Please complete the following section) WE DO NOT ACCEPT CREDIT CARDS, AMERICAN EXPRESS OR DINERS.(You can call us with this information when you receive our email of receipt if preferred)

CARD EXPIRES 3-DIGIT SCN

DATE:

Registered Company No: 4651386 VAT No: 238 0357 68

16-DIGIT CARD NUMBER

WHAT HAPPENS NOW?:

Once completed, this form must be signed & dated below and sent to our Wimbledon office address along with the attached Requirements Information and Checklist sheet & all required documentation for your visa by your preferred method of secure post. Documents can be hand delivered to our reception during 10am to 4pm only. If you require assistance during your visit, please contact us before you arrive to book an appointment with one of our specialists and ensure all documentation is completed to the best of your ability beforehand. We will not provide assistance without a prior booked appointment.You will receive an email to confirm receipt of your documents when they arrive at our office and your details entered onto our system. Payment will

be taken upon receipt of your documents and your application will be processed accordingly. For full information regarding embassy processing

times, fees and documentation required for particular applications, please see our Requirements Information and Checklist sheet.

BANK TRANSFER (An invoice will be emailed to you upon receipt)

DHL International LTD

Courier Subject to local area & availability. Please email info@travcour.com

For terms & conditions please visit www.dhl.co.uk

Applicable for E-visa applications only

SIGNATURE:

DISCLAIMER: Whilst every effort is made to issue your requirements, the embassy/consulate reserve the right to refuse your application & therefore no guarantees

can be provided. Governing regulations apply at all times. By placing an order with Travcour (UK) Ltd you confirm that you agree to our Terms and Conditions as

detailed at www.travcour.com . Travcour (UK) Ltd will not & cannot be held liable nor responsible for the actions, losses or delays of any nature incurred by

embassies, passport office, government offices, third party courier carrier, subcontracted couriers or Royal Mail. Our service is for the sole action of applying for

your visa and does not include any booked travel before or after the service is completed.

Personal Collection Please await our call to advise your documents are ready

STEP 3: PLEASE CONFIRM PAYMENT DETAILS. Payment in full must be enclosed in your delivery to us unless paying by Bank Transfer, in

which case an invoice will be provided to you upon receipt of your documents. The processing of your application will commence upon receipt of all fees. For a full breakdown of applicable fees, please see our Requirements Information and Checklist sheet.

Own Prepaid Envelope For security, please only send prepaid secure mail & note your tracking number

TELEPHONE NUMBER:

EMAIL ADDRESS:

STEP 2: PLEASE CONFIRM RETURN DELIVERY TYPE. Return fees are payable per return address (maximum of 4 passports). Carriers own

terms & conditions apply. We do not accept responsibility for the delivery of documents when using third party carriers party and by selecting this

option, you agree to the carriers terms only.

RETURN TYPE TERMS

POSTAL ADDRESS:

ADDRESS LINE 2:

ADRESS LINE 3:

POST/ZIP CODE:

FIRST NAME:

REQUIREMENTS INFORMATION & CHECKLISTFalcon House, Suite 2, 19 Deer Park Road, Wimbledon, SW19 3UX

Tel: 020 85431846

e-mail: info@travcour.com Website: www.travcour.com

Open Hours: (Mon – Fri) 9.00am to 5.00pm

PLEASE ENCLOSE THIS FORM WITH YOUR APPLICATION DOCUMENTS

PLEASE SELECT YOUR VISA TYPE:

DATE OF ENTRY: DATE OF EXIT:

DOCUMENTATION REQUIRED TO SEND(Please tick each document you have enclosed to us to ensure you are sending all required documentation) which can be sent via email or post

PROCESSING TIME REQUIRED (Please note these time scales are approximate and cannot be guaranteed)

Standard service: UP TO 8 Business days

FEES & CHARGES (INC. VAT) PER VISA TYPE (Excluding return postage)

e-Tourist 30 daye-Tourist 1 yeare-Tourist 5 yeare-Business 1 year ADVISORIES & IMPORTANT INFORMATION* (Please read this section carefully)

Registered Company No: 4651386 VAT No: 238 0357 68

DISCLAIMER: Please be aware that the information displayed on this document is not exhaustive and the provision of the listed requirements does not guarantee you a visa.

The Embassy or Consulate you are applying to reserve the right to ask for additional documents or fees if they deem it neccessary. The information provided is per the

official guidelines from the Immigration body you are applying to and any updates to these guidelines are added to this document as soon as we have been made aware of

them.

• Due to a large volume of applicants, all e-Visa applications sent to Travcour are processed on a first-come-first-serve basis. Upon completion of the process, Travcour will forward you the immigration decision by emailIf you have a criminal record, please complete the application for the full visa and not the E-visa.

• Please do not contact us if you are obtaining your own e-Visa online via Indian Immigration. This website is hosted and controlled by Indian

Immigration and is not affiliated with us in any way. We are therefore unable to provide technical assistance or support for independent applicants.

• Applicants of the eligible countries/territories may apply through Travcour a maximum of 120 days in advance (or 30 days for the 30 day visa)with a

minimum window of 5-10 days in advance of travel. For a full list of eligible countries, please see http://www.travcour.com/page/visa-applications/india.php

• e-Visa is valid for entry through the following 30 designated Airports/Seaports: Ahmedabad, Amritsar, Bagdogra, Bengaluru, Calicut, Chennai,

Chennai Seaport, Chandigarh, Cochin, Cochin Seaport, Coimbatore, Delhi, Gaya, Goa, Goa Seaport, Guwahati, Hyderabad, Jaipur, Kolkata,

Lucknow, Mangalore, Mangalore Seaport, Mumbai, Mumbai Seaport, Nagpur, Pune, Tiruchirapalli, Trivandrum, Varanasi & Vishakhapatnam

• You may apply for a maximum of 2 Indian e-Visas per calendar year. Your e-Visa is non-extendable, non-convertible & not valid for visiting

Protected/Restricted and Cantonment Areas

• Biometric details of the applicant will be mandatorily captured at Immigration upon arrival in India.

• Nationals of Yellow Fever affected countries or travellers arriving from these countries must carry their YELLOW FEVER VACCINATION CARD at

the time of arrival in India, otherwise they may be quarantined for 6 days upon arrival. Please visit the Ministry Of Health & Family Welfare for the

latest guidelines regarding yellow fever countries.

TOURIST TRAVELLERS BUSINESS TRAVELLERS

Embassy Visa Fee Travcour Service Charge Total to Send per Person£30.00£45.00£130.00£140.00

£30.00

£30.00£30.00£35.00

£60.00£75.00£160.00£175.00

COUNTRY: INDIA SERVICE: e-VISA

SURNAME:

1 YEAR e-BUSINESS VISA (MULTIPLE ENTRY)

Order Form & Checklist

Order Form & Checklist

Application Form Attached

Application Form Attached

1x Colour PhotographAny size, head& shoulders on a plain background.

1x Colour Clear Photocopy of Passport

Clear Photocopy of Passport

PhotographAny size, head& shoulders on a plain background.

Clear Photocopy of your PersonalBusiness Card

5 YEAR e-TOURIST VISA (MULTIPLE ENTRY)30 DAY e-TOURIST VISA (SINGLE ENTRY)

1 YEAR e-TOURIST VISA (MULTIPLE ENTRY)

APPLICANT'S PERSONAL INFORMATION (DETAILS MUST MATCH PASSPORT):

APPLICANT'S PASSPORT INFORMATION: (ALL DETAILS CAN BE FOUND ON THE I.D/PHOTO PAGE OF YOUR PASSPORT)

APPLICANT'S RESIDENTIAL ADDRESS AND CONTACT INFORMATION:

PHONE

NUMBER:

PAGE 1

ADDRESS

LINE 2:

ADDRESS

LINE 3:

POSTAL/ZIP

CODE:COUNTRY:

2NDNATIONALITY:

PLACE OF

ISSUE:

ADDRESS

LINE 1:

DATE OF

ISSUE

DATE OF

EXPIRY:

(DUAL NATIONALS) IF YOU HOLD ANY OTHER VALID PASSPORT OR IDENTIFACTION CERTIFICATE, PLEASE PROVIDE DETAILSBELOW:

DOCUMENT

NUMBER:

DATE OF

ISSUE:

NATIONALITY:PREVIOUS

NATIONALITY: (If applicable)

NATIONALITY ACQUIRED BY BIRTH OR NATURALIZATION?:

PASSPORT

NUMBER:

ISSUING

AUTHORITY:

TOWN OF

BIRTH:

COUNTRY OF

BIRTH:

RELIGION: EDUCATION: (Tick One)

SURNAME:FIRST & MIDDLE

NAMES:

SEX:DATE OF

BIRTH:MALE:

MANUAL INDIAN E- VISA APPLICATION(THIS FORM CAN BE TYPED OR HAND-WRITTEN)

TRAVCOUR (UK) LTD WILL COMPLETE THE ONLINE APPLICATION FOR YOU. IN ORDER TO DO THIS, WE REQUIRE YOU TO PROVIDE US WITH THE

INFORMATION BELOW IN FULL. ANY QUESTIONS LEFT BLANK WILL RESULT IN A DELAY IN THE COMPLETION OF YOUR VISA & THE APPLICATION WILL BE RETURNED.

IF YOU HAVE ANY QUESTIONS, PLEASE CONTACT A MEMBER OF OUR OPERATIONS TEAM ON 020 8543 1846 OR EMAIL INFO@TRAVCOUR.COM.

PLEASE NOTE COMPLETION OF ALL APPLICATIONS IS SUBJECT TO THE IMMIGRATION SYSTEM BEING IN OPERATION.

FEMALE:TRANS-GENDER:

DD D M M Y Y

SCHOOL/COLLEGE:UNIVERSITY/FURTHER EDUCATION:

BY BIRTH: NATURALIZATION:

DD D M M Y Y DD D M M Y Y

DD D M M Y Y

APPLICANT'S GRANDPARENT, PARENT AND SPOUSE INFORMATION: (BE AS ACCURATE AS POSSIBLE) This must be completed even if deceased.

APPLICANT'S OCCUPATIONAL INFORMATION (IF SELF-EMPLOYED, PLEASE USE YOUR OWN PERSONAL DETAILS):

VISA DETAILS (IF YOU ARE ENTERING INDIA MORE THAN ONCE, PLEASE USE DETAILS OF FIRST ENTRY):

PAGE 2

TYPE OF

VISA:TOURIST: BUSINESS: PLEASE LEAVE BLANK

DATE OF

ENTRY:

PORT OF

ARRIVAL:

IF YOU WERE/ARE IN ANY MILITARY/SEMI-MILITARY/POLICE/SECURITY ORGANIZATION, PLEASE PROVIDE DETAILS:

ORGANISATION: RANK:

DESIGNATION:PLACE OF

POSTING:

COMPANY

NAME:JOB TITLE:

WORK ADDRESS

HAVE EITHER OF YOUR GRANDPARENTS (PATERNAL/MATERNAL) EVER HELD A PAKISTANI PASSPORT OR BELONGED TO A PAKISTAN HELD

AREA? IF YES, PLEASE GIVE DETAILS BELOW:

NEITHER OF MY GRANDPARENTS HAVE HELD A PAKISTANI

PASSPORT OR BELONGED TO A PAKISTAN HELD AREA:

ONE/BOTH OF MY GRANDPARENTS HAVE HELD/HOLD A

PAKISTANI PASSPORT (PLEASE PROVIIDE DETAILS BELOW):

OCCUPATION: (TICK ONE)

EMPLOYEE:BUSINESS

PERSON/SELF-

EMPLOYED:

UNEMPLOYED:Go to next section

RETIRED:Go to next section

SPOUSE'S

NAME:

SPOUSE'S

NATIONALITY:

SPOUSES

COUNTRY OF

BIRTH:

SPOUSE'S

TOWN OF

BIRTH:

COUNTRY OF

BIRTH:

TOWN OF

BIRTH:

PLEASE PROVIDE YOUR MARITAL STATUS (PLEASE ONLY PROVIDE SPOUSE'S DETAILS BELOW IF MARRIED)

UNMARRIED: DIVORCED: WIDOWED: MARRIED:

COUNTRY OF

BIRTH:

TOWN OF

BIRTH:

MOTHER'S

NAMENATIONALITY:

FATHER'S

NAME:NATIONALITY:

DD D M M Y Y

DETAILS OF YOUR MOST RECENT PREVIOUS VISIT TO INDIA (IF APPLICABLE) AND GENERAL TRAVEL HISTORY :

PAGE 3

TELEPHONE NUMBER:

I CAN CONFIRM THAT I HAVE ANSWERED CORRECTLY AND TRUTHFULLY & THAT I DO NOT HAVE ANY CRIMINAL CONVICTIONS OR INVOLVED IN

ANY TERRORIST ACTIVITY.

I UNDERSTAND THAT ANY INFORMATION NOT SUPPLIED WILL RESULT IN A DELAY IN MY APPLICATION.

SIGNED:

NAME OF EMERGENCY

CONTACT IN THE UK:

ADDRESS LINE 1:

ADDRESS LINE 2:

ADDRESS LINE 1:

ADDRESS LINE 2:

TELEPHONE NUMBER:IF BUSINESS, PHONE AND EMAIL CONTACT

WHAT WAS THE PURPOSE OF YOUR PREVIOUS TRAVEL?

PLEASE LEAVE BLANK

DETAILS OF WHERE YOU/WHO CAN BE CONTACTED IN EVENT OF EMERGENCY DURING YOUR STAY IN INDIA (PLEASE PROVIDE FULL ADDRESS AND CONTACT DETAILS. IF YOU DO NOT HAVE DETAILS OF YOUR SPONSOR IN INDIA, YOU WILL NEED TO OBTAIN THIS VIA YOUR TOUR COMPANY OR TRAVEL AGENT AS IT CANNOT BE LEFT BLANK):NAME OF HOTEL/AGENTIF BUSINESS, CONTACT IN INDIA

PREVIOUS

PORT OF

ARRIVAL:

PREVIOUS VISA NUMBER: (LEAVE

BLANK IF UNKNOWN)

DATE OF ISSUE ON PREVIOUS VISA (IF YOU DO NOT HAVE THE

EXACT DATE, PLEASE PROVIDE AN APPROXIMATE DATE) :DD D M M Y Y Y Y