Reservation Detail
Salutation *
Mr
Mrs
Ms
Miss
First Name *
Last Name *
Date of Birth *
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December
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1988
1989
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1991
1992
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1994
1995
1996
1997
1998
1999
2000
Passport No *
Occupation *
Address
Tel:
Home
Office
Fax:
Home
Office
E-mail *
Country *
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia (Hrvatska)
Cuba
Cyprus
Czech Republic
Congo (DRC)
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Islas Malvinas)
Faroe Islands
Fiji Islands
Finland
France
French Guiana
French Polynesia
French Southern and Antarctic Lands
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia, Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Samoa
San Marino
São Tomé and Príncipe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
St. Helena
St. Kitts and Nevis
St. Lucia
St. Pierre and Miquelon
St. Vincent and the Grenadines
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Viet Nam
Virgin Islands (British)
Virgin Islands
Wallis and Futuna
Yemen
Zambia
Zimbabwe
Contact Detail in Case of Immergency
Salutation *
Mr
Mrs
Ms
Miss
First Name *
Last Name *
Passport No*
Occupation
Address
Tel:
Home
Office
Fax:
Home
Office
E-mail *
Country *
Afghanistan
Albania
Algeria
Andorra
Angola
Anguilla
Antigua & Bar.
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Azores
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia & Herz.
Botswana
Brazil
Brunei
Bulgaria
Burkina & Fasso
Burma
Burundi
Cambodia
Cameroon
Canada
Canary Is.
Canary Is.
Cape Verde
Cayman Is.
Cen. Afr. Rep.
Ceuta
Chad
Channel Is.
Chile
China
Colombia
Comoros
Congo
Cook Is.
Costa Rica
Croatia
Cuba
Cyprus
Czecho
Denmark
Djibouti
Dominica
Dominican Rep.
Ecuador
Egypt
El Salvador
Eq. Guinea
Estonia
Ethiopia
Faeroe Is.
Falkland Is.
Fed.St.of Micro.
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guiana
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia
Madagascar
Madeira
Malaysia
Maldives
Mali
Malta
Malwi
Marshall Is.
Martinique
Mauritania
Mauritius
Mayotte
Melila
Mexico
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Ant.
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
North Korea
North MarianasCh
Norway
Oman
Pakistan
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Is.
Poland
Polynesia
Portugal
Puerto Rico
Qatar
Rep. of Palau
Reunion
Romania
Russia
Rwanda
Saint Lucia
Samoa
San Marino
Sao Tome & E-Pri
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovak
Slovenia
Solomon Is.
Somalia
South Africa
South Korea
Spain
Sri Lanka
St. Helena
St. Kitts-Nevis
St. Pierre & Miq
St. Vin. & Gren.
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad &Tobago
Tunisia
Turkey
Turkmenistan
Turks &Caicos
Tuvalu
U.A.E.
U.K.
U.S.A.
Uganda
Ukraine
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuella
Vietnam
Virgin Is. (UK)
Virgin Is. (USA)
Wallis & Futuna
West Sahara
WestSamoa
Yemen North
Yugoslavia
Zaire
Zambia
Zimbabwe
Treking Detail
Trekking Region *
Annapurna Region
Everest Region
Langtang Region
Kanchenjunga Region
Makalu Region
Dolpo Region
Others...
Start Date *
1
2
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20
21
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26
27
28
29
30
31
January
February
March
April
May
June
July
August
September
October
November
December
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2006
2007
2008
2009
2010
Ending Date *
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2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
January
February
March
April
May
June
July
August
September
October
November
December
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2006
2007
2008
2009
2010
Date of Arrival *
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
January
February
March
April
May
June
July
August
September
October
November
December
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2006
2007
2008
2009
2010
Flight Detail *
No of Pax *
Types of Trekking *
Tea Housing
Camping
Other Interests
Hotel Booking
Rafting
Sight Seeing
Bungy Jumping
Mountain Flight
Peak Climbing
Cultural Tour
Mountain Biking
Tibet Tour
Bhutan Tour
Darjeeling Tour
Sikkim Tour
Payment Mode
By Cash
By Bank Draft
If any other information required, Please write down below
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