INDIAN RAILWAY CATERING AND TOURISM CORPORATION LTD.

(A Govt. of India Enterprise)

Application Form - Domestic Air Packages (DAP)

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1. Application & Package Details

Application No. (Optional)

Date *

Name of the Applicant *

Package Name

Package Code

Package Category

Boarding Point

Tour Start Date

Payment Mode

2. Passengers Details (Max 6)

3. Rooms & Occupancy Requirements

Total No. of Passengers

No. of Adults

No. of Children

Rooms Required

Occupancy (Number of passengers in each):

Single

Double

Triple

Child with Bed

Child without Bed

4. Address & Contact Details

Full Address *

City *

Pin Code *

Passenger Mobile No. *

Alternate Mobile No.

Landline No. with STD Code

Email ID *

Identity Proof & No. (Driving License / Passport / PAN / Aadhaar) *

5. Nominee Details

Nominee Name *

Relation *

Nominee Contact No. *

6. Medical Fitness & Declaration

I HEREBY ACKNOWLEDGE THAT I AM/WE ARE MEDICALLY FIT TO TRAVEL IN THIS TOUR

"I have been briefed about the package in detail, terms & conditions and cancellation policy mentioned in the brochure / website / requisition form. The details furnished above by me are correct and true to the best of my knowledge."

Signature of Guest / Group Leader / Representative *

(Sign above using your finger or mouse)

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