Trip Name
Trip Code
* Your
Name
Company
Name
* Street
Address, Home or office
(Postal address)
* Country
* Phone
(include country code)
Fax (include country code)
* Email
Address
I
am
style="FONT-FAMILY: Arial">
Single
Group Leader
Travel
Agent
With
my wife
Other(s)
With
my friend (s)
With
my kid (s)
If
others
Number
of Person (s)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
above
20
Please
select
traveling
Arrival in Nepal
January
February
March
April
May
June
July
August
September
October
November
December
Month
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Date
2007
2008
2009
2010
2011
2012
Year
Departure Date from Nepal
January
February
March
April
May
June
July
August
September
October
November
December
Month
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Date
2007
2007
2008
2009
2010
2011
2012
Year
* Programs
Select
Program
Trekking
Helicopter
tour/services
Hang-Gliding
Fly
with ultra-light aircraft
Hot
Air Ballooning
Wildlife
Safari
Biking
While
water rafing
Mountaineering/climbing
Touring
Sightseeing
Cycling
Hotair Balooning
Other
activities
I also
like to visit
Nepal
Tibet
Bhutan
India
China
My estimated cost for
this trip (in US$)
+ air fare
Airline
details
Arrival
time
Airport
Pickup Requested?
Yes
No
Airline
Booking Help Requested?
Yes
No
Hotel Booking Help Requested?
Yes
No
Hotel Category
Five Star
Four Star
Three Star
Budget
Room Type
SDL
Nos
1
2
3
4
5
6
7
8
9
10
DBL
Nos
1
2
3
4
5
6
7
8
9
10
TRPL
Nos
1
2
3
4
5
6
7
8
9
10
SUITE
Nos
1
2
3
4
5
6
7
8
9
10
Comments/questions &
your personal experiences/fitness or Any Special Request