STUDY TOUR - Registration Form

Please note: The information provided in this form will be used for flight booking, visa processing, and travel insurance. Kindly ensure that all details are entered accurately and as per your passport to avoid any errors or issues during the booking and application process.

Personal Information

Given Name(as per passport):

Surname(as per passport):

Date of Birth:

Gender:

Male

Female

Other

Nationality:

Passport Number:

Passport Expiry Date:

Contact Information

Email Address:

Phone Number:

Pan Number:

Present Address:

Passport Address:

Academic Information

Institution Name:

Institution Location:

Field of Study:

Year of Study:

French Language Proficiency Levels:

Parent Contact Information

Parent Contact Name:

Relationship:

Parent Phone Number:

Others

Dietary Restrictions:

Vegetarian

Vegan

Non-Vegetarian

Any other

Any other information, you need us to know:

List of Countries Visited:

Yes

Countries Visited :

Document Upload[Only PDF files accepted. File size must be less than 1 MB.]

Student PAN Copy:

Student Aadhar Copy:

Student Passport Front Page:

Student Passport Last Page:

Previous Travel Visas if any:

Parent PAN Copy:

Parent Aadhar Copy:

Payment Information

Please find the bank account details for account transfer and the QR code/scanner for online payment.

Amount Payable: ₹1,20,400/- per student

The above amount includes:

Visa processing
Travel insurance
Flight tickets
Program registration

Payment & Withdrawal Guidelines:

Last date for payment: 5th September 2026 (Withdrawal deadline: within 2 days from the date of payment)
Payment can be made either through bank account transfer or by scanning the attached QR code.
After making the payment, please share the payment confirmation/receipt for our records.
If you wish to withdraw, the request must be made within 2 days from the date of payment.
After the 2-day withdrawal period, the payment will be strictly non-refundable under any circumstances.
Please ensure you are fully committed to the program before making the payment.

Kindly complete the payment on or before 5th September 2026 to confirm your participation.

Account details:
Account number :- 2512563967
Account type :- Current
Account holder :- Immersion India
UPI ID :- immersionindia@kotak
Branch IFSC :- KKBK0008061
Branch name :- FRAZER TOWN

Payment Reference No.:
Amount :
Payment Receipt:

I hereby confirm that the information provided above is accurate and I agree to abide by the rules and guidelines of the study tour.