Movement Request Form (Passenger)

 

 

   PASSENGER RESERVATION FORM

 

 

 

 

WRITE IN PRINTED LETTERS ONLY

 

Submitted by:

 

 

 

 

 

Date of the FLIGHT  

 

Flight Code/Seat Number

 

Flight Office Receipt

 

  Date and Hour:

 

 

 

 

  Date  and Hour received by Flight Coordinator

 

 

Name of Agency/NGO  

 

Telephone and/or radio contact  

 

 

Departure

Arrival

Passenger's  Name in Full

ID No

Job Title

Reason of Trip

Remarks

Include security clearance details

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1. Carriages are subject to the liability rules and regulations of the Warsaw Convention of 12 Oct. 1923 and Sept. 1955  

 

2. The liability of the carrier and its officers for loss of life, personal injuries of passengers, or loss or damage of luggage and freight is limited in accordance with the above rules.

 

3. Passengers subscribe herewith to the conditions of the agreement between the (Name Organisation) and the owner/operator of the aircraft.

 

4. The signatory confirms herewith, that applicant is an employee or associate of the agency/organisation and certified that his travel is strictly for important official duties only.

 

Full Name of Agency Representative:

                                                              _________________________________________________

Agency Stamp