Hotel Yak & Yeti : Club Nirvana Membership Form

Fields marked with * are mandatory.

Name*
Date of birth*	DD/MM/YY
Spouse Name
Spouse Date of Birth	DD/MM/YY
Nationality*
Wedding Anniversary
Home Address:
Home Tel. No.
Company Name:
Company's Address
Occupation & Designation
Office Tel. No.
Email *
Comments
Word Verification*	Type characters you see in the picture. You can type either a or A (case insensitive)

I hereby apply for membership & agree that I will abide by the rules and regulations at the club nirvana, I have read rules and understood the rules & regulations, which apply to club nirvana. I confirm that the application form is correct. In the event of failure to do the above my membership may be cancelled immediately.

P.O. Box: 1016, Durbar Marg, Kathmandu, Nepal. Tel: +977 1 4248999 Fax: +977 1 4227782 e-mail: reservation@yakandyeti.com
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