raptim

English / Français / Deutsch

Newcomers : fullfill step 1 and step 2

Already raptim’s customer : fullfill only step 2

(* these fields must be filled out)

Step 1 - ELIGIBILITY REQUEST FORM (for newcomers only)
my name : *
first names : *
date of birth : (dd/mm/yy)
country of origin

I will travel for the following organization : (RAPTIM feels free to request credentials in writing before issuing “NGO rate” tickets)
Name of organization (in full) : *
Active in the following field: *
Full address : *
• Building, street & n°
• Area code
• City
• Country

Telephone : *
Fax :
E.mail : *
The person authorizing my travel is :
His/her function within the organization :

Step 2 - TICKET COST ESTIMATE
my name : *
first names : * (in the same order as on your passport)
Full address : *
• Building, street & n°
• Area code
• City
• Country

Telephone : *
Fax :
E.mail : *

Accompanied by :	persons

Name :
First Names :
date of birth : (dd/mm/yy)
(when special rates for juniors/seniors apply)

Name :
First Names :
date of birth : (dd/mm/yy)
(when special rates for juniors/seniors apply)

ITINERARY
From : *
• city • airport
• departure date (dd/mm/yy)
To : *
• city • airport
If several stops/segments are envisaged, please fill out a new field for each segment
Continuation to :
• city • airport
• departure date (dd/mm/yy)
Continuation to :
• city • airport
• departure date (dd/mm/yy)
Continuation to :
• city • airport
• departure date (dd/mm/yy)
Return from : *
• city • airport
Return to : *
• city • airport
• return date (dd/mm/yy)

Class :
First :
Business:
Economy :

If cheaper rates available I am willing to leave :	day(s) earlier day(s) later


Your remarks and requests to your travel agent :

IMPORTANT: Please check ! • if your passport is valid 6 months beyond your stay • if you need a visa and/or a specific vaccination • if you wish a travel, assistance and/or luggage insurance
Your additional remarks :

send the formular :