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              APPLICATION FORM
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PERSONAL INFORMATION

   NAME ______________________
   (upto 17 characters)

   DATE OF BIRTH __________________

   ADDRESS ________________________
	   ________________________
	   ________________________

   PHONE __________________________

   NATIONALITY ____________________

   UNIVERSITY/COLLEGE______________

   ________________________________
   (upto 17 characters)

   EMAIL ID________________________


Note : A Demand Draft of Rs.280/-
(Rs.250/- Enrolment fees & Rs.30/- Courier Charges) 
in favour of STIC Travels Pvt.Ltd. 
payable at issuing office city.

   I am applying for(Please tick one) : 
   [ ]International Students Identity Card - Rs.250/=
      (Full time /Part time Student & 12 yrs & above)
   [ ]International Youth Travel Card - Rs.250/=
      (Youth under 26 yrs)
   [ ]International Teachers Identity Card - Rs.250/=
      (Full time teacher/lecturer at a recognised educational institution)


   SIGNATURE_______________________

   DATE____________________________

Please attach following with the application form
* One passport size photo
* Photocopy of your student/teacher status
* Photocopy of your age proof(for ISIC,IYTC)


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            FOR OFFICE USE
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Issued By : 
Date of Issue :
Folio No. :


Student & Youth Division
G-55, Connaught Circus, New Delhi - 110001. 
Tel.:91-11-23731480/23711344