Nepal Mountain Trekking: Nepal trip application form, Booking and payment information form, Name, Sex, Street address, City of Born, Sate, Birth date, Nationality, Passpor number, Profession, Everest trekking, Nepal Annapurna trek, Langtang trekking, Rafting, Chitwan wildlife Safari, Rafting and Kayaking, Wildlife safari, Off road motorbiking, Tibet tours and treks

Booking & Payment Information

Nepal Mountain Trekking - Trip application form

Please complete, sign and fax at: + 977 1 4700898 with an advance of non-refundable bank deposit of US$ 200.00/- per person for the selected trip in the following bank detail:

Beneficiary: Nepal Mountain Trekking (P) Ltd. - Thamel - Kathmandu
A/C No: 010100061134
Bankers: Bank of Kathmandu Ltd. Kathmandu - Nepal
Telex No: 2820 BOK NP
Swift code: BOKLNPKA

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)......................................................................................................................................

Street address.................................................................................................................................................

City, State, Zip................................................................................................................................................

Home phone................................................. E-mail.........................................................................................

Birth date (D/M/Y)...........................................................................................................................................

Birth Place......................................................................................................................................................

Nationality (your passport issued country).........................................................................................................

Passport number.............................................................................................................................................

Profession .................................................Are you vegetarian / non-vegetarian? .............................................

Trekking experience........................................................................................................................................

Please specify if you have any comments..........................................................................................................

.....................................................................................................................................................................

.....................................................................................................................................................................

SIGNATURE....................................................................... DATE....................................................................

Print Me