School name*

Joining VYLI as*

Student (to be completed by parent/guardian of student) Accompanying Teacher

1. Personal Details of Student

1. Personal Details of Teacher

Full name as on passport

First name*

Middle names

Last name*

Date of birth:*

Day Month Year

Gender as on passport*

2. Passport Details

Current passport status*

Current passport with a date of expiry after April 2020 and at least 2 blank pages Currently in the process of applying for passport Will apply for passport immediately

Please note all passports will need to be presented at the pre trip information session on the 20th of June.

Passport number

Nationality as on passport

Passport place of issue

Passport issue date

Date

Passport expiry date

Date

Place of birth as listed on passport

Copy of personal details page of passport

Browse Files

Have you travelled internationally in the last 5 years?*

Yes No

If yes, please list all countries visited in those last 5 years

Digital Passport Photo

For your visa application you will need a digital passport photo. The requirements for these photos are VERY SPECIFIC and must match the following:

Image Format –JPEG
Size of Image – Minimum 10 KB – Maximum 300 KB
The height and width of the photo must be EQUAL(usually 2 in x 2 in)
The minimum dimensions are 350 pixels (width) x 350 pixels
(height).
The maximum dimensions are 1000 pixels (width) x 1000
pixels (height).
Background must be white or light in colour
Photo must be clear, with good resolution
Subject must face directly to the front, eyes open

See example photo that matches these requirements:

Passport photo upload

Browse Files

3. Emergency Contacts

It is required that your emergency contact be either your mother, father or guardian.

1st emergency contact name*

First Name Last Name

Relationship to you*

If other please give details

Relationship to you*

1st emergency contact e-mail*

example@example.com

1st emergency contact phone during work hours*

1st emergency contact phone outside work hours*

prefer mobile no.

2nd Emergency Contact

The 2nd emergency contact will be used if the 1st emergency contact is uncontactble.

2nd emergency contact name*

First Name Last Name

Relationship to you*

If other please give details

Relationship to you*

2nd emergency contact e-mail*

example@example.com

2nd emergency contact phone during work hours*

prefer mobile no.

2nd emergency contact phone outside work hours*

prefer mobile no.

4. Family Lineage

The Indian government requires that anyone applying for an Indian visa include details of their family lineage.

If you do not have this information please email VYLI@ceres.org.au

Nationality of mother