LEMBAGA PEMEGANG AMANAH TAMAN-TAMAN SABAH

(THE BOARD OF TRUSTEES OF SABAH PARKS)

MOUNTAIN CLIMBING RESERVATION FORM
LOT 45 & 46, TINGKAT 1-5, BLOCK SIGNATURE OFFICE, KK TIMES SQUARE,
COASTAL HIGHWAY, 88100 KOTA KINABALU, SABAH, MALAYSIA.
P. O. Box 10626, 88806 KOTA KINBALU, SABAH, MALAYSIA
TEL: +06088-523500 / 088-523531 FAX: +06088-523535 E-MAIL: sabahparks@gmail.com
ALL CLIMBERS ARE REQUIRED TO COMPLETE THIS FORM AND RETURN IT TO THE OFFICE WITHIN ONE WEEK
(THIS INFORMATION IS FOR CERTIFICATE, INSURANCE AND STATISTICAL PURPOSES)

NAME OF APPLICANT :
ADDRESS / E-MAIL :
CONTACT NUMBER : FAX NUMBER :
SUBMITTED BY (NAME) : TOUR GUIDE NAME & LICENSE NUMBER :
DATE OF SUBMISSION : DATE OF CLIMB : PERIOD OF CLIMB : ( ) DAYS ( ) NIGHT
BOOKING FOR ACCOMMODATION
SUTERA SANCTUARY LODGES. REF: LR/GL/WH/PL
LR/GL/WH/PL:
( 12)Pax ( ) PAX MOUNTAIN TORQ: ( ) PAX LEMAING HOSTEL: ROOM 1/2 (BED NO: )
VISITOR PARTICULAR
MALAYSIA
NO FULL NAME ( IN BLOCK LETTER ) I.C / PASSPORT NO SEX AGE NATIONALITY
SABAH SWK WMAL
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My group and I confirm that all the particulars given above are true :
………………………………………………………………..
( Signature Of Group Leader )
Name :
FOR SABAH PARKS OFFICE'S USE ONLY
LEMAING HOSTEL FEE + MEALS………………..…………………….. @RM200.00 Per person ( ) PAX RM _ Group Number
PERMIT FEE for NON-MALAYSIAN (18 YEARS & ABOVE) ……… @RM200.00 Per person ( ( ) )PAX
Per person
RM (_ ) PAX RM @RM200.00 Per person ( ) PAX
PERMIT FEE for NON-MALAYSIAN (BELOW 18 YEARS) …………. @RM80.00 Per person ( ) PAX RM
PERMIT FEE for MALAYSIAN (18 YEARS & ABOVE) ………………. @RM50.00 Per person ( ) PAX RM Guide's Name
PERMIT FEE for MALAYSIAN (BELOW 18 YEARS)……………………@RM30.00 Per person ( ) PAX RM
INSURANCE FEE ………………………………………………………………….. @RM 7.00 Per person ( ) PAX RM
TOTAL RM__________
TOTAL TOTTAL
Received By: Time: Approved By: Date:
Date:
Receipt No:
Signature Of Officer On Duty:
Signature & Co. stamp: Remarks:
ORIGINAL : KINABALU PARK DUPLICATE: MT GUIDE TRIPLICATE: INSURANCE