Business Executive Program

Applicant Name:

Given Name (small) Surname (Capital)

Applicants Passport Number:

F5843618

Applicant DOB:

03 January 1982

Visa Category:

B1

Hire Date:

15 March 2010

Position at Company:

I.T Analyst

Yearly income in India:

Rs. 9,10,000 /-

Purpose of Travel:

To Participate in Business Discussions with Alcatel - Lucent

Expected date of Departure:

13 June 2012

Expected Duration of Stay:

4 WEEKS

U.S. Contact & Position

James Offut, Director VitalQIP R&D

BLR/Emp no
Date: DD MM YYYY ( 1 day prior to your PA date)