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Registration Form for Indian Nationals

(in Benin, Cameroon, Chad and Nigeria)
(Students, Professionals, Visitors, Tourists & Others)

(Contact details will be used for Visa / Travel related information. High Commission’s e-newsletters / Events and E-mail alerts)

  • * Country of Residence
  • * Full Name (as in the Passport)
  • * Father’s / Husbands Name
  • * Date of Birth
  • * Place of Birth (City / State)
  • * Marital Status
  • * Sex
  • * Passport Number
  • * Place of Issue of Passport
  • * Date of Issue of Passport
  • * Occupation
  • * Password Note : password should be Minimum eight characters, at least one uppercase letter, one lowercase letter and one number
  • * Address Note : Address should be alphanumeric character only, No special charecter are allowed
  • * Mobile No./Phone No.
  • * Email
  • * Permanent address in India with Contact no. Note : Permanent address should be alphanumeric character only, No special charecter are allowed

Contact Person (s) in case of emergency

  • * Name
  • * Relationship
  • * Address Note : Address should be alphanumeric character only, No special charecter are allowed
  • * Phone No.
  • * Email
  • Alternative contact person details Note : Alternative contact person details should be alphanumeric character only, No special charecter are allowed
  • When did you arrive : In Benin / Cameroon/ Chad / Nigeria
  • Any other information of Importance Note : Any other information of Importance should be alphanumeric character only, No special charecter are allowed
  • * Captcha
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