High Mountain
Wave Trekking (P) Ltd.- Trip application
form
|
| Click
on your browser File option and select
Print to print this form. Please complete,
sign and fax at: + 977 1 4700769 with an
advance of the selected trip in the following
bank detail: |
Beneficiary: High Mountain
Wave Trekking (P) Ltd.
Thamel - Kathmandu
A/C
No:019 00106250019
Bankers: HIMALAYAN
BANK Ltd.
Tridevimarg - Kathmandu
- Nepal
Telex No: 2789 HIBA NP
Swift code:
HIMANPKA |
|
I
have applied to participate in (check
trips applied for & single supplement
option if desired).......................... |
| .......................................................................with
my personal information as follows: |
Name (as in passport)
........................................................................
Sex (M/F) .............................................. |
| Street address
........................................................................................... |
| City, State, Zip
........................................................................................... |
| Home phone....................................
E-mail ................................................... |
Birth date (D/M/Y)
...........................................
Birthplace ........................................ |
| Nationality (your
passport issued country) ........................
Passport number........................... |
| Date of issue
(D/M/Y) ............................... date
of expiration (D/M/Y) ....................... |
Profession ....................................................................
Are
you vegetarian / non-vegetarian? .................................. |
Trekking/Hiking/Biking
experience...................................................... |
| How high have you
been before?........................Please
specify if you have any comments.......... |
| ........................................................................................................................... |
| ................................................................................................... |
|
SIGNATURE .............................................................
DATE .......................................
|
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