Registration

Safina-e-Hujjaj.com

Hajj and Umrah Tour Operators

Registration

Please enter all the necessary (*) information before submitting.

Lastname*:

Firstname*:

Father's Fullname*:

Mother's Fullname*:

Gender*:

Marital Status*:

Do you Smoke*

Address*:

City*:

State*:

Zipcode / Postalcode*:

Country

Date of Birth*:

City of Birth*:

Country of Birth*:

Occupation*:

Nationality*:

Telephone: Bus:

Res*:

Fax:

E-Mail*:

Passport No.*:

Date of Issue*:

Place of Issue*:

Date of Expiry*:

Medical Information

Have you ever suffered from (check all that apply):

Diabetes	Heart Problems
Arthritis	Blood Pressure
Allergies (specify)

Please register me for:

Umra Only Umra and Ziyarat Hajj Only Hajj and Ziyarat

Passport size photographs required - Ladies MUST be in Hijab.

(Four photographs for Umra and Hajj, and eight photographs for Ziyarat).

A cashier's check in favor of Safina-e-Hujjaj for the amount of USD 250.00 is required with your registration application form and the balance is due on request..

Submitting this form implies that you have read and fully understood the Liability and Responsibility information.

D-9 Block "H" North Nazimabad Karachi, Pakistan
phone: 6646799, 4226323-4, 4226315, fax: 6646853

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