2009/2010 - Fixed Departure Trips
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B O O K I N G - F O R M

 
Name *

as appear on the Passport
Date of Birth *
Sex * M F
Passport Number *
Country *
Occupation *
E-mail address *
Phone with countrycode *
Phone1 ( Mobile/residence)
 
Emergency contact information if incase
   
Name
Tel
email
Relation
 
Do you have any medical conditions we should be aware of?
Yes/No, if yes, explain please:
   
Medical / Rescue insurance
Name of Insurance Company
Hot line telephone No
Kathmandu arrival date, time and flight
Departure date from Kathmand:
 
   
 
 
 
 
 
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