<?

$ntrek=$_GET['ntrek'];
$ntour=$_GET['ntour'];
$npeak=$_GET['npeak'];
$nexpedition=$_GET['nexpedition'];
$nflight=$_GET['nflight'];
$nsport=$_GET['nsport'];

//Nepal Treks

if($ntrek=="basecamp")          { $trip="Everest Base Camp Trekk";  }
else if($ntrek=="salpa")          { $trip="Salpa Trek";  }
else if($ntrek=="khumbu")          { $trip="Khumbu Valley Trek";  }
else if($ntrek=="gokyo")             { $trip="Gokyo Chola Pass Trek";  }
else if($ntrek=="kalapathar")        { $trip="Everest Base Camp Kalapathar Trek";  }

else if($ntrek=="annapurna_dhaulagiri")     { $trip="Annapurna Dhaulagiri Trek";  }
else if($ntrek=="circuit")     { $trip="Annapurna Circuit Trek";  }	
else if($ntrek=="annapurna")   { $trip="Annapurna Base Camp Trek";  }
else if($ntrek=="ghorepani")         { $trip="Ghorepani Poonhill Trek";  }
else if($ntrek=="jomsom")      { $trip="Jomsom Muktinath Trek";  }
else if($ntrek=="siklish")     { $trip="Siklish Trek";  }	
else if($ntrek=="royal")       { $trip="Royal Trek";  }
else if($ntrek=="mardi")       { $trip="Mardi Himal Trek";  }
else if($ntrek=="royal")       { $trip="Royal Trek";  }

else if($ntrek=="langtang")          { $trip="Langtang Trek";  }
else if($ntrek=="langtang_gosai")          { $trip="Langtang Gosaikunda Trek";  }
else if($ntrek=="langtang_hela")          { $trip="Langtang Gosaikunda Helambu Trek";  }
else if($ntrek=="helambu")          { $trip="Helambu Trek";  }
else if($ntrek=="gosaikunda")        { $trip="Gosaikunda Trek";  }
else if($ntrek=="ganesh_langtang")    { $trip="Ganesh Himal Langtang Trek";  }

else if($ntrek=="dolpo1")          { $trip="Upper Dolpo Trek 32 Days";  }
else if($ntrek=="dolpo2")          { $trip="Upper Dolpo Trek 31 Days";  }
else if($ntrek=="dolpo3")          { $trip="Lower Dolpo Trek 14 Days";  }
else if($ntrek=="dolpo4")          { $trip="Lower Dolpo Trek 21 Days";  }
else if($ntrek=="dolpo5")          { $trip="Lower Dolpo Trek 18 Days";  }
else if($ntrek=="dolpo6")          { $trip="Upper Dolpo Trek 22 Days";  }


else if($ntrek=="mustang")          { $trip="Trekking In Mustang";  }
else if($ntrek=="manaslu")          { $trip="Trekking In Manaslu";  }
else if($ntrek=="makalu")          { $trip="Trekking In Makalu";  }
else if($ntrek=="kanchanjunga")          { $trip="Trekking In Kanchanjunga";  }
else if($ntrek=="ganesh_himal")          { $trip="Trekking In Ganesh Himal";  }
else if($ntrek=="makalu")          { $trip="Trekking In Makalu";  }
else if($ntrek=="rolwaling")          { $trip="Trekking In Rolwaling";  }
	
else if($ntrek=="dhaulagiri_round")     { $trip="Dhaulagiri Round Trek";  }
else if($ntrek=="round_dhaulagiri")     { $trip="Round Dhaulagiri Trek";  }
else if($ntrek=="dhaulagiri_round")     { $trip="Dhaulagiri Round Trek";  }


else if($ntrek=="dhampus")     { $trip="Dhampus Trek";  }	
else if($ntrek=="churen")      { $trip="Churen Base Camp Dhaulagiri Trek";  }
	

else if($npeak=="tharpu")       { $trip="Tharpu Chuli Peak";  }	
else if($npeak=="singuchuli")   { $trip="Singu Chuli Peak";  }
else if($npeak=="ramdung")      { $trip="Ramdung Peak";  }	
else if($npeak=="pisang")       { $trip="Pisang Peak";  }
else if($npeak=="mera")         { $trip="Mera Peak";  }	
else if($npeak=="island")       { $trip="Island Peak";  }
else if($npeak=="hiunchuli")    { $trip="Hiunchuli Peak";  }	


else if($ntour=="tour1")     { $trip="Round Trip All Nepal Tour";  }	
else if($ntour=="tour2")     { $trip="A Week In Nepal Tour";  }
else if($ntour=="tour3")     { $trip="A Grand NEpal Tour";  }	
else if($ntour=="tour4")     { $trip="Temples, Mountains and Tigers Tour";  }
else if($ntour=="tour5")     { $trip="Nepal Himalayas Tour";  }	


else if($nexpedition=="dhaulagiri")       { $trip="Dhaulagiri Expedition";  }
else if($nexpedition=="churen")           { $trip="Churen Himal Expedition";  }	
else if($nexpedition=="chamlang")         { $trip="Chamlang Expedition";  }
else if($nexpedition=="baruntse")         { $trip="Baruntse Expedition";  }	
else if($nexpedition=="api_himal")        { $trip="Api Himal Expedition";  }
else if($nexpedition=="amadablam")        { $trip="Amadablam Expedition";  }	
else if($nexpedition=="api_himal")        { $trip="Api Himal Expedition";  }
else if($nexpedition=="shisapangma")      { $trip="Shisapangma Expedition";  }
else if($nexpedition=="manaslu")          { $trip="Manaslu Expedition";  }
else if($nexpedition=="makalu")           { $trip="Makalu Expedition";  }
else if($nexpedition=="pumori")           { $trip="Pumori Expedition";  }
else if($nexpedition=="kanchanjunga")     { $trip="Kanchanjunga Expedition";  }
else if($nexpedition=="shisapangma")      { $trip="Shisapangma Expedition";  }
else if($nexpedition=="cho_oyu")     { $trip="Cho Oyu Expedition";  }

else if($nflight=="domestic")          { $trip="Domestic Air Ticketing";  }
else if($nflight=="mountain")          { $trip="Mountain Flight";  }
else if($nflight=="international")     { $trip="International Air Ticketing";  }

else if($nsport=="bungee")          { $trip="Bungee Jumping";  }	
else if($nsport=="paragliding")     { $trip="Paragliding";  }
else if($nsport=="biking")          { $trip="Mountain Biking";  }

?>
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<title>Trekking in nepal, Nepal trekking, Nepal treks, Nepal tour, Travel, Mountaineering, Whitewater rafting, Wildlife tour, Mountaineering, Tibet tour, Bhutan tour, India tour</title>

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                        Nepal Trekking</span></p></td>
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						<td><p style="margin: 6px 0px 2px 1px">
						<img border="0" src="picture/arrow2.gif" width="7" height="5" hspace="8"><span class="m2f1"><a href="nepal/trekking_in_annapurna.php">Annapurna 
                        Region</a></span></p></td>
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						<img border="0" src="picture/arrow2.gif" width="7" height="5" hspace="8"><span class="m2f1"><a href="nepal/trekking_in_everest.php">Everest 
                        Region</a></span></p></td>
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						<img border="0" src="picture/arrow2.gif" width="7" height="5" hspace="8"><span class="m2f1"><a href="nepal/trekking_in_langtang.php">Langtang 
                        Region</a></span></p></td>
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						<img border="0" src="picture/arrow2.gif" width="7" height="5" hspace="8"><span class="m2f1"><a href="nepal/trekking_in_manaslu.php">Manaslu 
                        Trek</a></span></p></td>
					</tr>
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						<td><p style="margin: 3px 0px 2px 1px">
						<img border="0" src="picture/arrow2.gif" width="7" height="5" hspace="8"><span class="m2f1"><a href="nepal/trekking_in_dhaulagiri.php">Dhaulagiri 
                        Trek</a></span></p></td>
					</tr>
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						<td><p style="margin: 3px 0px 2px 1px">
						<img border="0" src="picture/arrow2.gif" width="7" height="5" hspace="8"><span class="m2f1"><a href="nepal/trekking_in_dolpo.php">Dolpo 
                        Trek</a></span></p></td>
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						<img border="0" src="picture/arrow2.gif" width="7" height="5" hspace="8"><span class="m2f1"><a href="nepal/trekking_in_mustang.php">Mustang 
                        Trek</a></span></p></td>
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						<img border="0" src="picture/arrow2.gif" width="7" height="5" hspace="8"><span class="m2f1"><a href="nepal/trekking_in_kanchanjunga.php">Kanchanjunga 
                        Trek</a></span></p></td>
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						<td><p style="margin: 3px 0px 2px 1px">
						<img border="0" src="picture/arrow2.gif" width="7" height="5" hspace="8"><span class="m2f1"><a href="nepal/trekking_in_ganesh_himal.php">Ganesh 
                        Himal</a></span></p></td>
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						<td><p style="margin: 3px 0px 2px 1px">
						<img border="0" src="picture/arrow2.gif" width="7" height="5" hspace="8"><span class="m2f1"><a href="nepal/trekking_in_rolwaling.php">Rolwaling 
                        Trek</a></span></p></td>
					</tr>
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						<td><p style="margin: 3px 0px 2px 1px">
						<img border="0" src="picture/arrow2.gif" width="7" height="5" hspace="8"><span class="m2f1"><a href="nepal/trekking_in_makalu.php">Makalu 
                        Trek</a></span></p></td>
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						<td>&nbsp;</td>
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						<td height="25">
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						<td>
                        <table cellpadding="0" cellspacing="0" class="t">
                          <tr>
                            <td width="12" rowspan="2">
                            <img border="0" src="picture/curve_orange1.gif" width="12" height="35"></td>
                            <td>
                            <img border="0" src="picture/1.gif" width="1" height="12"></td>
                            <td width="12" rowspan="2">
                            <img border="0" src="picture/curve_orange2.gif" width="12" height="35"></td>
                          </tr>
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                            <td class="rbg" height="23"><p style="margin: 3px 0px 0px 0px" align="center">
                            <span class="mh1">Reservation</span></p></td>
                          </tr>
                        </table>
                        </td>
					</tr>
					<tr>
						<td class="rbgm">
				<table width="406" border="0" align="center" cellpadding="2" cellspacing="4">
              <form name="form1" method="post" action="http://www.nepaltrekkings.com/friends_forum/reservation_mail.php">
                <tbody>
                  <tr> 
                    <td colspan="2"><span class="mf"><span class="mf2">Trip 
                      Details :</span></span></td>
                  </tr>
                  <tr> 
                    <td width="25%"><span class="mf">Program*</span></td>
                    <td> 
                      <? if($ntrek!="" || $npeak!="" || $ntour!="" || $nexpedition!="" || $nflight!="" || $nsport!="") { ?>
                       <input name="tripname" type="text"   id="tripname" style="font-family: Verdana; font-size: 12; color: #FF0000; border: 1px solid #000000;font-weight:bold" value="" size="35">
                                           <? } ?>
										   </td>
                  </tr>
                  <tr>
                    <td><span class="mf">Budget per Person<font face="Verdana, Arial, Helvetica, sans-serif">*</font></span></td>
                    <td>
                    <input name="budget" type="text" id="budget" style="border-style:solid; border-width:1px; font-family: Verdana; font-size: 11; color: #000000; " size="10"></td>
                  </tr>
                  <tr> 
                    <td><span class="mf">No. of Person<font face="Verdana, Arial, Helvetica, sans-serif">*</font></span></td>
                    <td>
                    <input name="nop" type="text" id="fname1" style="border-style:solid; border-width:1px; font-family: Verdana; font-size: 11; color: #000000; " size="10"></td>
                  </tr>
                  <tr> 
                    <td colspan="2"><span class="mf"><span class="mf2">Personal Details 
                      :</span></span></td>
                  </tr>
                  <tr> 
                    <td><span class="mf">Full Name*</span></td>
                    <td><input name="fname" type="text" id="fname" style="border-style:solid; border-width:1px; font-family: Vedana; font-size: 11; color: #000000; " size="30"></td>
                  </tr>
                  <tr> 
                    <td><span class="mf">Email<font face="Verdana, Arial, Helvetica, sans-serif">*</font></span></td>
                    <td><input name="email" type="text" id="email" style="border-style:solid; border-width:1px; font-family: Vedana; font-size: 11; color: #000000; " size="30"></td>
                  </tr>
                  <tr> 
                    <td><span class="mf">Address<font face="Verdana, Arial, Helvetica, sans-serif">*</font></span></td>
                    <td><input name="address" type="text" id="fname1" style="border-style:solid; border-width:1px; font-family: Verdana; font-size: 11; color: #000000; " size="30"></td>
                  </tr>
                  <tr> 
                    <td><span class="mf">Country</span></td>
                    <td><select name="country" id="select" style="border-style:solid; border-width:1px; FONT-SIZE: 11; font-family:Verdana; color:#000000; background-color:#FFFFFF">
                        <option value="0" selected>[ Please select your country 
                        ] </option>
                        <option value="0"> ---------------------------------------------</option>
                        <option value="Afghanistan">Afghanistan </option>
                        <option value="Albania">Albania </option>
                        <option value="Algeria">Algeria </option>
                        <option value="American Samoa">American Samoa </option>
                        <option value="Andorra">Andorra </option>
                        <option value="Angola">Angola </option>
                        <option value="Anguilla">Anguilla</option>
                        <option value="Antarctica">Antarctica</option>
                        <option value="Antigua &amp; Barbuda">Antigua &amp; Barbuda</option>
                        <option value="Argentina">Argentina </option>
                        <option value="Armenia, CIS">Armenia, CIS</option>
                        <option value="Aruba">Aruba </option>
                        <option value="Australia">Australia</option>
                        <option value="Austria">Austria</option>
                        <option value="Azerbaijan, CIS">Azerbaijan, CIS</option>
                        <option value="Bahamas">Bahamas</option>
                        <option value="Bahrain">Bahrain</option>
                        <option value="Bangladesh">Bangladesh</option>
                        <option value="Barbados">Barbados</option>
                        <option value="Belarus, CIS">Belarus,CIS</option>
                        <option value="Belgium">Belgium </option>
                        <option value="Belize">Belize </option>
                        <option value="Benin">Benin </option>
                        <option value="Bermuda">Bermuda </option>
                        <option value="Bhutan">Bhutan</option>
                        <option value="Bolivia">Bolivia </option>
                        <option value="Bosnia &amp; Herzegovina">Bosnia &amp; 
                        Herzegovina</option>
                        <option value="Botswana">Botswana</option>
                        <option value="Bouvet Island">Bouvet Island</option>
                        <option value="Brazil">Brazil </option>
                        <option value="British Indian Ocean Territory">British 
                        Indian Ocean Territory</option>
                        <option value="Brunei Darussalem">Brunei Darussalem</option>
                        <option value="Bulgaria">Bulgaria</option>
                        <option value="Burkina Faso">Burkina Faso</option>
                        <option value="Burundi">Burundi</option>
                        <option value="Cambodia">Cambodia </option>
                        <option value="Cameroon">Cameroon </option>
                        <option value="Canada">Canada </option>
                        <option value="Cape Verde">Cape Verde</option>
                        <option value="Cayman Islands">Cayman Islands</option>
                        <option value="Central African Republic">Central African 
                        Republic</option>
                        <option value="Chad">Chad </option>
                        <option value="Chile">Chile </option>
                        <option value="China, People's Republic">China, People's 
                        Republic</option>
                        <option value="Christmas Island">Christmas Island</option>
                        <option value="Cocos (Keeling) Islands">Cocos (Keeling) 
                        Islands</option>
                        <option value="Colombia">Colombia</option>
                        <option value="Comoros">Comoros</option>
                        <option value="Congo">Congo</option>
                        <option value="Cook Islands">Cook Islands</option>
                        <option value="Costa Rica">Costa Rica</option>
                        <option value="Cote d'Ivoire">Cote d'Ivoire</option>
                        <option value="Croatia">Croatia</option>
                        <option value="Cuba">Cuba</option>
                        <option value="Cyprus">Cyprus</option>
                        <option value="Czech Republic">Czech Republic</option>
                        <option value="Denmark">Denmark</option>
                        <option value="Djibouti">Djibouti</option>
                        <option value="Dominica">Dominica</option>
                        <option value="Dominican Republic">Dominican Republic</option>
                        <option value="East Timor">East Timor</option>
                        <option value="Ecuador">Ecuador</option>
                        <option value="Egypt">Egypt</option>
                        <option value="El Salvador">El Salvador</option>
                        <option value="Equatorial Guinea">Equatorial Guinea</option>
                        <option value="Eritrea">Eritrea</option>
                        <option value="Estonia">Estonia</option>
                        <option value="Ethiopia">Ethiopia</option>
                        <option value="Falkland Islands">Falkland Islands</option>
                        <option value="Faroe Islands">Faroe Islands</option>
                        <option value="Fiji">Fiji</option>
                        <option value="Finland">Finland</option>
                        <option value="France">France</option>
                        <option value="French Guiana">French Guiana</option>
                        <option value="French Polynesia ">French Polynesia</option>
                        <option value="French Southern Territories">French Southern 
                        Territories</option>
                        <option value="Gabon">Gabon</option>
                        <option value="Gambia">Gambia</option>
                        <option value="Georgia, CIS">Georgia, CIS</option>
                        <option value="Germany">Germany</option>
                        <option value="Ghana">Ghana</option>
                        <option value="Gibraltar">Gibraltar</option>
                        <option value="Greece">Greece</option>
                        <option value="Greenland">Greenland</option>
                        <option value="Grenada">Grenada</option>
                        <option value="Guadeloupe">Guadeloupe</option>
                        <option value="Guam">Guam</option>
                        <option value="Guatemala">Guatemala</option>
                        <option value="Guinea">Guinea</option>
                        <option value="Guinea-Bissau">Guinea-Bissau</option>
                        <option value="Guyana">Guyana</option>
                        <option value="Haiti">Haiti</option>
                        <option value="Heard and McDonald Islands">Heard and McDonald 
                        Islands</option>
                        <option value="Honduras">Honduras </option>
                        <option value="Hong Kong">Hong Kong</option>
                        <option value="Hungary">Hungary </option>
                        <option value="Iceland">Iceland </option>
                        <option value="India">India </option>
                        <option value="Indonesia">Indonesia </option>
                        <option value="Iran">Iran </option>
                        <option value="Iraq">Iraq </option>
                        <option value="Ireland">Ireland </option>
                        <option value="Israel">Israel </option>
                        <option value="Italy">Italy </option>
                        <option value="Jamaica">Jamaica </option>
                        <option value="Japan">Japan </option>
                        <option value="Jordan">Jordan </option>
                        <option value="Kazakhstan, CIS">Kazakhstan, CIS</option>
                        <option value="Kenya">Kenya </option>
                        <option value="Kiribati">Kiribati </option>
                        <option value="Korea, North">Korea, North</option>
                        <option value="Korea, South">Korea, South</option>
                        <option value="Kuwait">Kuwait </option>
                        <option value="Kyrgyzstan, CIS">Kyrgyzstan, CIS</option>
                        <option value="Lao People's Democratic Republic">Lao People's 
                        Democratic Republic</option>
                        <option value="Latvia">Latvia</option>
                        <option value="Lebanon">Lebanon</option>
                        <option value="Lesotho">Lesotho</option>
                        <option value="Liberia">Liberia</option>
                        <option value="Libyan Arab Jamahiriya">LibyanArab Jamahiriya</option>
                        <option value="Liechtenstein">Liechtenstein</option>
                        <option value="Lithuania">Lithuania</option>
                        <option value="Luxembourg">Luxembourg</option>
                        <option value="Macau">Macau</option>
                        <option value="Macedonia">Macedonia</option>
                        <option value="Madagascar">Madagascar</option>
                        <option value="Malawi">Malawi</option>
                        <option value="Malaysia">Malaysia</option>
                        <option value="Maldives">Maldives</option>
                        <option value="Mali">Mali</option>
                        <option value="Malta">Malta</option>
                        <option value="Marshall Islands">Marshall Islands</option>
                        <option value="Martinique">Martinique</option>
                        <option value="Mauritania">Mauritania</option>
                        <option value="Mauritius">Mauritius</option>
                        <option value="Mayotte">Mayotte</option>
                        <option value="Mexico">Mexico</option>
                        <option value="Micronesia">Micronesia</option>
                        <option value="Moldova, CIS">Moldova, CIS</option>
                        <option value="Monaco">Monaco</option>
                        <option value="Mongolia">Mongolia</option>
                        <option value="Montserrat">Montserrat</option>
                        <option value="Morocco">Morocco</option>
                        <option value="Mozambique">Mozambique</option>
                        <option value="Myanmar">Myanmar</option>
                        <option value="Namibia">Namibia</option>
                        <option value="Nauru">Nauru</option>
                        <option value="Nepal">Nepal</option>
                        <option value="Netherlands">Netherlands</option>
                        <option value="Netherlands Antilles">Netherlands Antilles</option>
                        <option value="New Caledonia">New Caledonia</option>
                        <option value="New Zealand">New Zealand</option>
                        <option value="Nicaragua">Nicaragua</option>
                        <option value="Niger">Niger</option>
                        <option value="Nigeria">Nigeria</option>
                        <option value="Niue">Niue</option>
                        <option value="Norfolk Island">Norfolk Island</option>
                        <option value="Northern Mariana Islands">Northern Mariana 
                        Islands</option>
                        <option value="Norway">Norway</option>
                        <option value="Oman">Oman</option>
                        <option value="Pakistan">Pakistan</option>
                        <option value="Palau">Palau</option>
                        <option value="Panama">Panama</option>
                        <option value="Papua New Guinea">Papua New Guinea</option>
                        <option value="Paraguay">Paraguay</option>
                        <option value="Peru">Peru</option>
                        <option value="Philippines">Philippines</option>
                        <option value="Pitcairn Islands">Pitcairn Islands</option>
                        <option value="Poland">Poland</option>
                        <option value="Portugal">Portugal</option>
                        <option value="Puerto Rico">Puerto Rico</option>
                        <option value="Qatar">Qatar</option>
                        <option value="Reunion">Reunion</option>
                        <option value="Romania">Romania</option>
                        <option value="Russian Federation, CIS">Russian Federation, 
                        CIS</option>
                        <option value="Rwanda">Rwanda</option>
                        <option value="S. Georgia and S. Sandwich Isls.">S. Georgia 
                        and S. Sandwich Isls.</option>
                        <option value="Saint Kitts &amp; Nevis">Saint Kitts &amp; 
                        Nevis</option>
                        <option value="Saint Lucia">Saint Lucia</option>
                        <option value="Saint Vincent &amp; The Grenadines">Saint 
                        Vincent &amp; The Grenadines</option>
                        <option value="Samoa">Samoa</option>
                        <option value="San Marino">San Marino</option>
                        <option value="Sao Tome and Principe">Sao Tome and Principe</option>
                        <option value="Saudi Arabia">Saudi Arabia</option>
                        <option value="Senegal">Senegal</option>
                        <option value="Seychelles">Seychelles</option>
                        <option value="Sierra Leone">Sierra Leone</option>
                        <option value="Singapore">Singapore</option>
                        <option value="Slovakia">Slovakia</option>
                        <option value="Slovenia">Slovenia</option>
                        <option value="Solomon Islands">Solomon Islands</option>
                        <option value="Somalia">Somalia</option>
                        <option value="South Africa">South Africa</option>
                        <option value="Spain">Spain</option>
                        <option value="Sri Lanka">Sri Lanka</option>
                        <option value="St. Helena">St. Helena</option>
                        <option value="St. Pierre &amp; Miquelon">St.Pierre &amp; 
                        Miquelon</option>
                        <option value="Sudan">Sudan</option>
                        <option value="Suriname">Suriname</option>
                        <option value="Svalbard and Jan Mayen Islands">Svalbard 
                        and Jan Mayen Islands</option>
                        <option value="Swaziland">Swaziland</option>
                        <option value="Sweden">Sweden</option>
                        <option value="Switzerland">Switzerland</option>
                        <option value="Syrian Arab Republic">Syrian Arab Republic</option>
                        <option value="Taiwan">Taiwan</option>
                        <option value="Tajikistan, CIS">Tajikistan, CIS</option>
                        <option value="Tanzania">Tanzania </option>
                        <option value="Thailand">Thailand</option>
                        <option value="Togo">Togo</option>
                        <option value="Tokelau">Tokelau</option>
                        <option value="Tonga">Tonga</option>
                        <option value="Trinidad &amp;Tobago">Trinidad &amp;Tobago</option>
                        <option value="Tunisia">Tunisia</option>
                        <option value="Turkey">Turkey</option>
                        <option value="Turkmenistan, CIS">Turkmenistan, CIS</option>
                        <option value="Turks &amp; Caicos Islands">Turks &amp; 
                        Caicos Islands</option>
                        <option value="Tuvalu">Tuvalu</option>
                        <option value="Uganda">Uganda</option>
                        <option value="Ukraine, CIS">Ukraine, CIS</option>
                        <option value="United Arab Emirates">United Arab Emirates</option>
                        <option value="United Kingdom [GB] ">United Kingdom</option>
                        <option value="United States">United States</option>
                        <option value="Uruguay">Uruguay</option>
                        <option value="US Minor Outlying Islands">US Minor Outlying 
                        Islands</option>
                        <option value="Uzbekistan, CIS">Uzbekistan, CIS</option>
                        <option value="Vanuatu">Vanuatu </option>
                        <option value="Vatican City State (Holy See)">Vatican 
                        City State (Holy See)</option>
                        <option value="Venezuela">Venezuela </option>
                        <option value="Vietnam">Vietnam </option>
                        <option value="Virgin Islands (British)">Virgin Islands 
                        (British)</option>
                        <option value="Virgin Islands (USA)">Virgin Islands (USA)</option>
                        <option value="Wallis and Futuna Islands">Wallis and Futuna 
                        Islands</option>
                        <option value="Western Sahara">Western Sahara</option>
                        <option value="Yemen">Yemen </option>
                        <option value="Yugoslavia">Yugoslavia </option>
                        <option value="Zaire">Zaire </option>
                        <option value="Zambia">Zambia</option>
                        <option value="Zimbabwe">Zimbabwe</option>
                      </select></td>
                  </tr>
                  <tr> 
                    <td><span class="mf">Tel/Mobile/Fax</span></td>
                    <td>
                    <input name="phone" type="text" id="fname1" style="border-style:solid; border-width:1px; font-family: Verdana; font-size: 11; color: #000000; " size="30"></td>
                  </tr>
                  <tr> 
                    <td colspan="2"><span class="mf"><span class="mf2">Arrival Details :</span></span></td>
                  </tr>
                  <tr> 
                    <td><span class="mf">Arrival Date</span></td>
                    <td><span class="mf"> 
                      <select size="1" name="amonth" style="border-style:solid; border-width:1px; font-family: v; font-size: 11; color: #000000; ">
                        <option selected>Month</option>
                        <option value="January">January</option>
                        <option value="February">February</option>
                        <option value="March">March</option>
                        <option value="April">April</option>
                        <option value="May">May</option>
                        <option value="June">June</option>
                        <option value="July">July</option>
                        <option value="August">August</option>
                        <option value="September">September</option>
                        <option value="October">October</option>
                        <option value="November">November</option>
                        <option value="December">December</option>
                      </select>
                      <select size="1" name="aday" style="border-style:solid; border-width:1px; font-family: Verdana; font-size: 11; ">
                        <option selected>Date</option>
                        <option value="0">0</option>
                        <option value="1">1</option>
                        <option value="2">2</option>
                        <option value="3">3</option>
                        <option value="4">4</option>
                        <option value="5">5</option>
                        <option value="6">6</option>
                        <option value="7">7</option>
                        <option value="8">8</option>
                        <option value="9">9</option>
                        <option value="10">10</option>
                        <option value="11">11</option>
                        <option value="12">12</option>
                        <option value="13">13</option>
                        <option value="14">14</option>
                        <option value="15">15</option>
                        <option value="16">16</option>
                        <option value="17">17</option>
                        <option value="18">18</option>
                        <option value="19">19</option>
                        <option value="20">20</option>
                        <option value="21">21</option>
                        <option value="22">22</option>
                        <option value="23">23</option>
                        <option value="24">24</option>
                        <option value="25">25</option>
                        <option value="26">26</option>
                        <option value="27">27</option>
                        <option value="28">28</option>
                        <option value="29">29</option>
                        <option value="30">30</option>
                        <option value="31">31</option>
                      </select>
                      <select size="1" name="ayear" style="font-family: Verdana; font-size: 11; color: #000000; border: 1px solid #808080">
                        <option selected>Year</option>
                        <option value="2006">2006</option>
                        <option value="2007">2007</option>
                        <option value="2008">2008</option>
                        <option value="2009">2009</option>
                        <option value="2010">2010</option>
                        <option value="2011">2011</option>
                        <option value="2012">2012</option>
                      </select></font>
                      </span></td>
                  </tr>
                  <tr> 
                    <td><span class="mf">Departure Date</span></td>
                    <td><span class="mf"> 
                      <select size="1" name="dmonth" style="font-family: v; font-size: 11; color: #000000; border: 1px solid #808080">
                        <option selected>Month</option>
                        <option value="January">January</option>
                        <option value="February">February</option>
                        <option value="March">March</option>
                        <option value="April">April</option>
                        <option value="May">May</option>
                        <option value="June">June</option>
                        <option value="July">July</option>
                        <option value="August">August</option>
                        <option value="September">September</option>
                        <option value="October">October</option>
                        <option value="November">November</option>
                        <option value="December">December</option>
                      </select>
                      <select size="1" name="dday" style="font-family: Verdana; font-size: 11; border: 1px solid #808080">
                        <option selected>Date</option>
                        <option value="0">0</option>
                        <option value="1">1</option>
                        <option value="2">2</option>
                        <option value="3">3</option>
                        <option value="4">4</option>
                        <option value="5">5</option>
                        <option value="6">6</option>
                        <option value="7">7</option>
                        <option value="8">8</option>
                        <option value="9">9</option>
                        <option value="10">10</option>
                        <option value="11">11</option>
                        <option value="12">12</option>
                        <option value="13">13</option>
                        <option value="14">14</option>
                        <option value="15">15</option>
                        <option value="16">16</option>
                        <option value="17">17</option>
                        <option value="18">18</option>
                        <option value="19">19</option>
                        <option value="20">20</option>
                        <option value="21">21</option>
                        <option value="22">22</option>
                        <option value="23">23</option>
                        <option value="24">24</option>
                        <option value="25">25</option>
                        <option value="26">26</option>
                        <option value="27">27</option>
                        <option value="28">28</option>
                        <option value="29">29</option>
                        <option value="30">30</option>
                        <option value="31">31</option>
                      </select>
                      <select size="1" name="dyear" style="font-family: Verdana; font-size: 11; color: #000000; border: 1px solid #808080">
                        <option selected>Year</option>
                        <option value="2006">2006</option>
                        <option value="2007">2007</option>
                        <option value="2008">2008</option>
                        <option value="2009">2009</option>
                        <option value="2010">2010</option>
                        <option value="2011">2011</option>
                        <option value="2012">2012</option>
                      </select></font>
                      </span></td>
                  </tr>
                  <tr> 
                    <td><span class="mf">Airlines</span></td>
                    <td>
                    <input name="airlines" type="text" id="fname2" style="border-style:solid; border-width:1px; font-family: Verdana; font-size: 11; color: #000000; " size="30"><STRONG><FONT face=Arial> 
                      </FONT></STRONG></td>
                  </tr>
                  <tr>
                    <td><span class="mf">Flight No</span></td>
                    <td><input name="flight" type="text" id="fname1" style="border-style:solid; border-width:1px; font-family: Verdana; font-size: 11; color: #000000; " size="15"> 
                      &nbsp;<span class="mf">Time&nbsp; 
                      <input name="time" type="text" id="time" style="font-family: Verdana; font-size: 10; color: #000000; border: 1px solid #808080" size="10"> <font color="#CCFF99">&nbsp;</font></span></td>
                  </tr>
                  <tr>
                    <td><span class="mf">Airport Pickup </span></td>
                    <td><span class="mf"><font color="#CCFF99">&nbsp;<select name="pickup" size="1" style="font-family: Verdana; font-size: 11; border: 1px solid #808080">
                        <option selected value="Yes">Yes</option>
                        <option  value="No">No</option>
                      </select>
                      </font> 
                      </span></td>
                  </tr>
                  <tr> 
                    <td><span class="mf">Mode of Payment</span></td>
                    <td> <input name="payment" type="radio" value="Creditcard" checked> 
                      <span class="mf">Credit Card 
                      <input type="radio" name="payment" value="Cash">
                      Cash 
                      <input type="radio" name="payment" value="Bank transfer">
                      Bank Transfer 
                      <input type="radio" name="payment" value="Travellers Cheque">
                      Travellers Cheque&nbsp; </span> </td>
                  </tr>
                  <tr>
                    <td><span class="mf">Interested Areas</span></td>
                    <td width="28%" > <span style="font-size: 9pt"><font color="#CCFF99"> 
                      <select name="destination_nepal" size="1" id="service" style="font-family: Verdana; font-size: 11; border: 1px solid #808080">
                        <option selected value="0">Nepal</option>
                        <option value="0">-------------------------- </option>
                        <option value="Trekking">Trekking</option>
                        <option value="Peak Climbing">Peak Climbing</option>
                        <option value="Expedition">Expedition</option>
                        <option value="River Rafting">River Rafting</option>
                        <option value="Wildlife Safari">Wildlife Safari</option>
                        <option value="Adventure Sports">Adventure Sports </option>
                      </select>
                      </font></span> </font> </td>
                  </tr>
                  <tr>
                    <td>&nbsp;</td>
                    <td > <span style="font-size: 9pt"><font color="#CCFF99"> 
                      <select name="D2" size="1" id="select5" style="font-family: Verdana; font-size: 11; border: 1px solid #808080">
                        <option selected value="0">Tibet</option>
                        <option value="0">-------------------------- </option>
                      </select>
                      </font></span> </td>
                  </tr>
                  <tr> 
                    <td>&nbsp;</td>
                    <td width="28%" > <span style="font-size: 9pt"><font color="#CCFF99"> 
                      <select name="destination_bhutan" size="1" id="select2" style="font-family: Verdana; font-size: 11; border: 1px solid #808080">
                        <option value="0" selected>Bhutan</option>
                        <option value="0">-------------------------- </option>
                      </select>
                      </font></span> </font> </td>
                  </tr>
                  <tr> 
                    <td>&nbsp;</td>
                    <td > <span style="font-size: 9pt"><font color="#CCFF99"> 
                      <select name="D3" size="1" id="select6" style="font-family: Verdana; font-size: 11; border: 1px solid #808080">
                        <option value="0" selected>India</option>
                        <option value="0">-------------------------- </option>
                      </select>
                      </font></span> </td>
                  </tr>
                  <tr> 
                    <td><span class="mf">Other Specify</span></td>
                    <td><textarea name="comments"  rows="5" cols="50" style="font-family: Verdana; font-size: 9;"></textarea> </td>
                  </tr>
                  <tr> 
                    <td colspan="2"><div align="center"> 
                        <input type="submit" name="Submit" value="Submit">
                        &nbsp;&nbsp; 
                        <input name="reset" type="reset" id="reset" value="Clear">
                      </div></td>
                  </tr>
              </form>
            </table>
				        </td>
					</tr>
					<tr>
						<td>
						<table cellpadding="0" cellspacing="0" class="t">
							<tr>
								<td>
								<img border="0" src="picture/curve_orange3.gif" width="12" height="14"></td>
								<td width="382" class="rbgb">
								<img border="0" src="picture/1.gif" width="1" height="1"></td>
								<td>
								<img border="0" src="picture/curve_orange4.gif" width="12" height="14"></td>
							</tr>
						</table>
						</td>
					</tr>
					<tr>
						<td>&nbsp;</td>
					</tr>
				</table>
				</td>
			</tr>
		</table>
		</td>
	</tr>
	<tr>
		<td height="25">
					</td>
	</tr>
	<tr>
		<td>&nbsp;
        </td>
	</tr>
	</table>

</body>

</html>