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1. Name:
2. Designation: Professor Assoc. Professor Asst. Professor Sen. Lecturer PDF Res. Scholar Blank
3. Scale of Pay/Fellowship:
4. Place of visit :
5. Period of visit:
6. Absence from Head quarter from to
on deputation :
on earned leave :
on sabbatical leave :
7. Purpose of visit : (Please enclose the copy of the Invitation letter by the host)
8. Facilities provided by the host:
Fare : By Train : Yes No By Air : Yes No Both ways : : Blank Yes No One way : : Blank Yes No
Local expenses : : Blank Yes No Accommodation : : Blank Yes No Travel : : Blank Yes No
Other incidental Expenses
(Please specify the details)
9. Any other visit abroad, if carried out during the current financial year :
10. Amount of advance required :
Fare : (one way / both ways):both ways one way By Train : Yes No By Air : Yes No
Health Insurance : at actual / Rs.
Visa Fees : at actual / Rs.
Per diem to take care of : the local expenses (as per rule)
Advance money Total:
I undertake to submit the tour report along with form / questionnaire, duly filled in, within 15 days of my return to the headquarters.
Date: dd: : 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 mm: JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC yy: 201020112012