Al-Makkawi Hajj & Umrah Travel ltd

Head office: 72 Hobmoor Road, Small Heath. Birmingham. B10 9BU

Tel: 0121 753 0378 Fax: 0121 753 0624 Mob: 07939 034 162

Email: www.almakkawitravel.com

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Application Form (please fill in with maximum details possible as many of the questions mentioned below are the requirements of the Royal Embassy of Saudi Arabia)

This form must be filled in as supplied by the company. No alteration is accepted. The pagination MUST NOT be changed or amended.

Customer Details:

First Name...... Other Name...... Last Name......

Address ......

……...... Postcode ...... Profession ………………………………..

Tel ...... Mob ...... E mail ......

Present Nationality ………………………………………….. Previous Nationality …………………………………………

Marital Status: …………………………. Gender ………….. Are you able to walk unassisted? Yes No

When was your last Hajj …………………….…………………… When was your last Umrah? ………..………………...

Emergency contact:

First Name...... Last Name...... Relationship......

Address ......

……...... Postcode ...... Profession ………………………………..

Tel ...... Mob ...... E mail ......

Travel details:

Application for Hajj Application for Umrah Other ………………………………..………………..

Group Name : ...... Duration......

Expected Departure Date:...... Expected Return Date:......

Health details:

Q1. Are you fit enough to travel for Hajj / Umrah, etc? Yes No

(If no, do you have anybody travelling with you to help you? Yes No If No (Sorry we cannot accept your application).

If yes , Please provide his/her Name …………………………………. Relationship ………………………………………..

Q2. Can you walk continually for at least 30 minutes? Yes No

(If no, do you have any body travelling with you to help you? Yes No If No (Sorry we cannot accept your application).

Any other health issues? Yes No if yes, please state:………………………..……………………………...

………………………………………………………………………………………………………………………………………

Any Special arrangement you will require?......

Please note that we do not provide any additional services for anybody who is unable to travel for the journey also be independent.

Please provide details of the accompanied person(s) for Pilgrims under the age of18 ONLY

No / Name / Gender / Date of Birth / Nationality / Mahram Name (if applicable) / His relationship to you (if applicable) / Profession
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2
3
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Terms and Conditions Apply

Please visit our website www.almakkawitravel.com for the terms and conditions.

I hereby confirm that I have read and agree to the terms and conditions of Al-Makkawi Hajj and Umrah Travel Ltd. I, the undersigned understand that I act on behalf of the pilgrim(s) mentioned above and I take the full responsibility and make the full commitment on their behalf. I also take the responsibility of updating all the pilgrim(s) applying with me for the package and air tickets I purchased for myself and on their behalf.

Name …...... Signed ...... Date......

Al- Makkawi staff use only

Application received on ………………….. and checked by………… ………….. Date…………………….

Remarks: ……………………………………………………………….……………………………………………….

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