Set up by Government of Gujarat Block 16, 3rd Floor, Udhyog Bhavan, Gandhinagar Tel : +91-79-2323 8278,2323 8280 Fax : +91-79-2323 8279
Fee for issuing card is ........$
Application for"GUJARAT CARD"
Latest P.P size Colour Photograph
I hereby apply for the card having following details
(To be certified by self & registered affiliate)
Name in Full
(First Name)(Father's Name)(Surname)
Birth Date
Present Address
Phone
(O)
(R)
(O)
(R)
E-mail
Occupation
Area of Expertise
Field of Interest
Are you NRI or Citizen of ................................. (Mention Country)
Details of Passport
Passport No.Valid up to Issuing Authority (Address)
Domicillary details (for Gujarat)
Birth Place : ...................... Village : .................... Taluka : ................ District : ....................
Name & Address of First Name Address
Phone Fax
Information stated above is true to the best of my knowledge & belief. "Gujarat-Card" be issued to me as per the rules - regulations of "Gujarat-Card" scheme of Gujarat State Non-Resident Gujaratis' Foundation, Gandhinagar.
Date Place Signature of applicant
( To be filled by office bearer of registered Gujarati Mandal, an affliliate of G.S.N.R.G. Foundation Gandhinagar )
I do hereby acknowledge that I know Shri/Smt/Miss ...........................................since ......... years. Infomration stated in the above application is true to the best of my knowledge & belief. On the basis of my personal knowledge & information stated above I recommend him for issue GUJARAT-CARD
