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+ 977-1-4700898 e-mail ( ).
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Beneficiary: WhiteWater Nepal (P) Ltd. - Thamel – Kathmandu
A/C No: 010100061440
Bankers: Bank of Kathmandu Ltd – Thamel Branch - 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) ............................................ Birthplace ................................................................
Nationality (your passport issued country) ....................... Passport number......................................
Profession .................................................Are you vegetarian / non-vegetarian? ...........................
Rafting experience............................................................................................................................
Please specify if you have any comments.........................................................................................
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SIGNATURE ......................................................................... DATE ...................................................