HIGH COMMISSION OF INDIA MAURITIUS

Welcome to High Commission of India Mauritius

HIGH COMMISSION OF INDIA

6TH Floor, L.I.C. Building, President John Kennedy Street
Port Louis, MAURITIUS

Tele: (230) 211 2380 Email: hicom.cons@intnet.mu
Fax: (230) 208 6859 Website: www.indiahighcom-mauritius.org

1.	NAME (AS IN PASSPORT) *	:
2.	DATE OF BIRTH *	:
3.	PLACE OF BIRTH *	:
4.	FATHER’S NAME *	:
5.	WHETHER SINGLE / MARRIED / WIDOWED / DIVORCED	:
6.	PASSPORT DETAILS :- *
	i) PASSPORT NUMBER	:
	ii) PLACE OF ISSUE	:
	iii) DATE OF ISSUE	:
7.	EDUCATIONAL QUALIFICATIONS *	:
8.	SPECIALISATION, IF ANY	:
9.	PROFESSION / OCCUPATION *	:
10.	EMPLOYER DETAILS :- *
	I) NAME OF ORGANISATION	:
	ii) ADDRESS	:
	iii) PHONE NUMBER	:
	iv) FAX NUMBER	:
11.	PERMANENT ADDRESS IN INDIA	:
12.	PRESENT RESIDENTIAL ADDRESS IN MAURITIUS	:
13.	RESIDENTIAL PHONE NUMBER / MOBILE NUMBER	:
14.	E-MAIL ADDRESS, IF ANY	:
15.	NAME OF SPOUSE *	:
16.	NATIONALITY OF SPOUSE *	:
17.	NUMBER OF FAMILY MEMBERS / DEPENDANTS RESIDING IN MAURITIUS * (ALL HOLDERS OF INDIAN PASSPORTS MUST REGISTER INDIVIDUALLY ALSO)	:
18.	DETAILS OF PERSON IN INDIA TO BE CONTACTED DURING ANY EMERGENCY *
	i) NAME	:
	ii) ADDRESS	:
	iii) PHONE NUMBER	:
19.	DATE OF ARRIVAL IN MAURITIUS	:
20.	PROBABLE PERIOD OF STAY IN MAURITIUS	: