Adam Travel Hajj Registration Form

HAJJ PACKAGE REGISTRATION FORM

[ Please use UPPERCASE while typing in your information. ]

PACKAGE DETAILS

Select Your Package*

Room Occupancy*

Package Price

Deposit

PERSONAL DETAILS

Last Name (as in Passport)*

First Name (as in Passport)*

Middle Name (as in Passport)

Profession

Date Of Birth*

Place of Birth*

Gender* Male Female

Marital Status*

Previous Nationality*

Present Nationality*

PASSPORT DETAILS

Passport Number*

Place of Issue*

Date of Issue*

Date of Expiry*

CONTACT DETAILS

Home Address*

Suburb*

State*

Post Code*

Home Phone

Mobile

Business Address

Business Phone

Email*

OTHER DETAILS

Name of Mahram (for females only)

Relation to Mahram

Mother's Name

Sect (Sunni, Shia, etc)

Medical History (if any)

Blood Type

IN CASE OF EMERGENCY

Contact Name

Relation

Full Address

Contact Phone

PAYMENT

DEPOSIT and FINAL PAYMENT

Australian Currency Account (AUD)

Payable To: ADAM TRAVEL PTY LTD
Bank: Commonwealth Bank of Australia
BSB No: 063-122
Account No: 10686701
Bank Address: 488 Sydney Rd, Coburg, VIC 3058

OR

American Currency Account (USD)

Payable To: ADAM TRAVEL PTY LTD
Bank: Commonwealth Bank of Australia
BSB No: 063-122
Account No: 10870074
Bank Address: 488 Sydney Rd, Coburg, VIC 3058

Seats are available on a ‘FIRST COME, FIRST SERVED” basis.

Deposit of AU$3,500 of the package price is required upon booking.

DECLARATION

I hereby declare that I am a Muslim. I further declare that I am in good health to perform Hajj. I consent that I have read carefully, understood and agreed to the Terms and Conditions Agreement including the details of the package which I have selected. I enclose my deposits as stated and agree to pay the balance as agreed.*

AUTHENTICATION

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Adam Travel - Deluxe Hajj 2024 Tours Luxury Hajj Packages Umrah 2024 Tours Packages

HAJJ PACKAGE REGISTRATION FORM

[ Please use UPPERCASE while typing in your information. ]

DEPOSIT and FINAL PAYMENT

Seats are available on a ‘FIRST COME, FIRST SERVED” basis.

Deposit of AU$3,500 of the package price is required upon booking.

Thank You!

Your submission is received and we will contact you very soon.

Hajj Registration & Booking

Umrah Registration & Booking

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