Registration form

for travel to China as IPPTA delegate

1-Name: 2-IPPTA membership No:

3-Designation 4-Mill:

5-Email address: 6-Mobile number

7-Age: 8-Date of Birth

9-Passport No : 10-Date of Issue

11-Date of expiry: 12-Attach copy of first 2 and last 2 pages of passport.

13-Is trip being sponsored by your company or is it self financed:

14-Details of remittance of Rs 10000/ done in favour of IPPTA:

15-Would you like to book air ticket through IPPTA:

16-Would you like IPPTA to arrange Visa for you?

17-Would you like IPPTA to arrange travel insurance for you?

18-Would you like IPPTA to arrange China sim for you?

19-In case of emergency who should be contacted. Pl give name and phone number:

20-Do you suffer from any disease? 21-Are you fit for travel in cold weather?

22 – Are you veg/ Non veg 23 – you prefer Indian/ Chinese/ continental food

24-Would you like to join trip to Great Wall of China or arrive a day later:

25- Would you like to return to India with the group on 10th or want to return later. In case you desire to return to India later ,

please let us know your schedule by 30th Oct which will help us avail quoted fare.

On confirmation of acceptance of registration I agree to remit a sum of Rs 47000 / ( Forty seven thousand) including visit to

Great wall of China ( arrival on 3rd Dec) or Rs 40000/ ( forty thousand) without visit to great wall of china( arrival on 4th Dec )

in IPPTA’s favour to cover overseas travel cost( Hotel/ local travel/ food) after adjusting advance paid within 7 days of

receiving the approval. I shall also remit towards Visa/ insurance etc in case I desire to avail this facility. In case of my failure

to remit the desired amount in time the registration amount may be forfeited and registration may be treated as cancelled.

I wish to confirm following:

1 I have read and undershoot the purpose of registration fees as given in SOP of registration and confirm its

acceptance in totality as per terms and condition given their in. I also accept that IPPTA’s decision in all respect

shall be final. In case of any unforeseen circumstances, accident/ mishap, loss of baggage, theft or death IPPTA or

its officials would not be held responsible.

Name Signature

Date: