For Encyclope dia Indica Shiaii
Brief Account
Present & Past Imamia Writers & Translators
Please attach passport size photograph
Name….----------------------------------------------------------------------------------------------------------------------------------------------------------------------Father's Name………….-----------------------------------------------------------------------------------------------------------------------------------Date & Place of Birth…………………………-------------------------------------------------------------------------------------------Teachers…………..---------------------------------------------------------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Qualifications………….----------------------------------------------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Profession……-----------------------------------------------------------------------------------------------------------------------------------------------------Office Address……………..---------------------------------------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Local Address……….--------------------------------------------------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Permanent Address………-------------------------------------------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Books…………………-------------------------------------------------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Book's Name…………….----------------------------------------------------------------------------------------------------------------------------------Language…..---------------------------------------------------------------------------------------------------------------------------------------------------------------Topic…..-------------------------------------------------------------------------------------------------------------------------------------------------------------------
Size & Pages…………………….-------------------------------------------------------------------------------------------------------------------Published or non-published……………………..-------------------------------------------------------------------------------------------Year and place of publication…………………………-----------------------------------------------------------------------------Press name & Address………………----------------------------------------------------------------------------------------------------------Location & condition of manuscript, if unpublished…..----------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Office Phone………..--------------------------------------- Home Phone…………………….----------------------------------E-mail……..---------------------------------------------------------------------------- Mobile………----------------------------------------------Date of Expiry……………-------------------------------------------------------------------------------------------------------------------------------Place of Death……………------------------------------------------------------------------------------------------------------------------------------Place of Burial………….-------------------------------------------------------------------------------------------------------------------------------Chronogramme (Tareekh) of death…………………………………….----------------------------------------------
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Source…..---------------------------------------------------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Name, address, phone nos. etc of person reporting……………………………………..---------------------
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Signature Date Place
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Note:- Plz. attach also a post-card size or larger 'full length' photograph Plz. use separate sheet(s), if necessary
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