ROYAL NEPALESE EMBASSY
(VISA APPLICATION FORM)

Passport Size Photo to be Pasted Here

Barakhamba Road ,
New Delhi-110001
Cable Address:
Rarnjanak,
New Delhi

Telex: 31-4383 NEMB IN
Phone : 3328066

1. Surname : Mr_/Mrs_/Miss ______________________________________
(Block Letters)

Other Name___________________________

2. Nationality ________________________

4. Date of Birth ___________ (b) Place of Birth _______________

5. Occupation ______________________________________________________

6. Particulars of Passport : (a) Passport No _______________ (b) Date of issue __________

7. Probable date of arrival in Nepal ______________________

8. Address in Nepal _______________________________________________________________

9. Duration of stay in Nepal _____________________

10. Purpose of visit to Nepal ___________________________________

11. Expenses of stay in Nepal to be born by ____________________________________________

12. Place of entry to Nepal ____________________________________________________

13. Means of transportation _____________________________________________________

14. If wife & or child (ren) is/are in the passport and is/are travelling please state wife's &/ or child's

(ren) name (s) in full and (s) of birth (S) ____________________________________

_____________________________________________________________________________

_____________________________________________________________________________

15. Is this your first visit to Nepal ? If no, how many times and when was your last visit

_____________________________________________________________________________

Date :

Signature of applicant

Type: Tourist
Visa fee received :
Date of issue -
Visa number :

Signature of Visa Officer Royal Nepalese Embassy

New Delhi

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