Essey

Shri Amarnathji Yatra 2011
Form A

Application Form
FULL line: __________________________________________________________ GENDER (Tick ? as applicable): ? Male ? Female; Age: ___Yrs; Blood Group: _____ NAME OF SPOUSE / FATHER: ___________________________________________ ADDRESS: ___________________________________________________________ STATE: _________________________________________ PIN _________________ netmail (if any): __________________________________ CONTACT / PHONE NO. MOBILE +91

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Telephone with STD Code / Mobile number of a close relative who may be contacted in wooing of any emergency ________________. To, The Chief Executive Officer, Shri Amarnathji Shrine bill of fare Jammu / Srinagar Sir,

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I may please be issued a Yatra permission for Darshan at the Holy Cave of Shri Amartnathji. I propose to let the Yatra on ______________ from Baltal / Chandanwari* Entry Barrier on ____/___/2011 and perform Darshan at the Holy Cave on ____/____/2011.



I certify that (i) I am not suffering from any Cardiac / respiratory ailment; (ii) I am physically and mentally garment to undertake the journey to the Shri Amarnathji Holy Cave during June-August 2011; (iii) I am fully aware that the Shri Amarnathji Yatra involves an arduous trek in the broad(prenominal) mountain ranges involving a climb upto an altitude of 14000 ft. above aver develop sea level. I, __________________________, son/daughter/wife of ___________, nominate Mr/Ms_________________________________, age ________, who is my _____________ (relationship) to be paid the redress proceeds upon payment of the insurance claim in case of my death due to accident, as per the applicable Insurance cover provided by the Shrine Board.** I solemnly undertake to abide by the Dos & Donts for the Shri Amarnathji Yatra, as laid down by the SASB and printed on the reverse of the Yatra Permit. _______________________
Full Signature of Applicant Date: __________________

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