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FORM FOR CLEARANCE OF THE

MINISTRY OF HUMAN RESOURCE DEVELOPMENT


GOVERNMENT OF INDIA
FOR VISIT OF FOREIGN NATIONALS TO
INDIAN INSTITUTE OF TECHNOLOGY KHARAGPUR, INDIA.

1 Name :

2 Father’s Name :

3 Nationality :

4 Date of birth :

5 Place of birth :

6 Number, Date &


Place of Issue of Passport :

7 Current residential address :

8 Permanent residential address :

9. Profession:

10. Place of Employment:

11. Academic Credentials:

12. Purpose of visit:

13. Period of visit:

14. Email:

15. Day time Phone:

Address of Indian Embassy where you


16. will be applying for your visa:

Coordinator of your visit at


17. IITKGP/Dept :

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