High Mountain Wave Trekking - Trip application form
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Click on your browser File option and select Print to print this form. Please complete using block letters, sign and Fax at: + 977 1 4700769 with a non-refundable bank deposit of 30% of total booking sum each for the selected trip in the following bank details or just send your Credit card Details via Fax mail. |
Beneficiary: High Mountain Wave Trekking (P) Ltd. - Thamel - Kathmandu
A/C No: 00106250019
Bankers: HIMALAYAN BANK Ltd - Tridevimarg - Kathmandu - Nepal
Telex No: 2789 HIBA NP; Swift code: HIMANPKA; Fax: +977 1 4222800
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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.......................................................................................................................................
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| How high have you been before?........................Please specify if you have any comments................... |
| ...................................................................................................................................................... |
| ....................................................................................................................................................... |
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SIGNATURE ......................................................................... DATE .......................................
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