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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: