Service Request

We pleased to provide our group desk travel service to all travel agents when you require a special or complex group travel arrangement, meetings, incentives, and events. As our preferred client, you are assured of the best service and price quotation. Please click the appropriate inquiry selection and provide the necessary details for a complete quotation.

Flight
Hotel
Tour
Visa
Helicopter
Insurance

Group Request for Flight

Flying From *

Flying To *

Date / Time *

Date / Time (copy)

Number of Person

Adult

Selected Value: 1

Child

Selected Value: 0

Infant

Selected Value: 0

Group Name

Contact Person Name *

Phone/Mobile No *

Contact Email

Special Notes

Group Request for Hotel

CheckIn Date *

CheckOut Date *

Preffered Hotel Name *

Hotel Location *

City *

Country *

Number of Person :

Adult

Selected Value: 1

Child

Selected Value: 0

Infant

Selected Value: 0

Number of Room :

Single

Selected Value: 0

Double

Selected Value: 0

Triple

Selected Value: 0

Deluxe

Selected Value: 0

Suit

Selected Value: 0

Other Specify

Selected Value: 0

Group Name

Contact Person Name *

Phone/Mobile No *

Contact Email

Special Notes

Group Request for Tour

City/Cities *

Travel Date *

Number Of Days *

Hotel Type *

InterCity Transfer Preference

Number of Person :

Adult

Selected Value: 1

Child

Selected Value: 0

Infant

Selected Value: 0

Group Name

Contact Person Name *

Phone/Mobile No *

Contact Email

Special Notes

Group Request for Visa

Desire Country *

Number of Person :

Adult

Selected Value: 1

Child

Selected Value: 0

Infant

Selected Value: 0

Group Name

Contact Person Name *

Phone/Mobile No *

Contact Email

Special Notes

Request for Helicopter

Flying From *

Flying To *

Journey Date *

Number of Person :

Adult

Selected Value: 1

Child

Selected Value: 0

Infant

Selected Value: 0

Group Name

Contact Person Name *

Phone/Mobile No *

Contact Email

Special Notes

Individual Insurance Form

Name *

Date Of Birth *

Phone/Mobile No *

Address *

Address Line 1

City

State / Province / Region

Passport Number *

Purpose Of Trip *

Proposed date of departure from Bangladesh *

Number of days stay outside Bangladesh *

Geographical Limit *

Accompanying person(s) *

(If yes please complete separate form for each person)

Medical History to Be Completed by The Proposer(Please Answer the Following Questions In Yes or No)

Are you in good health and free from physical and mental disease or infirmity? *

First Choice
Second Choice

Have you ever suffered from:

Number of Person :

a) Any neruous, mental or psychiatric disease, slipped disc or other spinaldisorder, fainting episode, blackout, fit or paralysis of any kind? *

First Choice
Second Choice

b) High blood pressure, heart diseases including ischemic heart diseasepiles, varicose veins, other circulatory disorders or rheumatic fever? *

First Choice
Second Choice

c) Hernia, any rheumatic or joint disease, urinary disease or diabetes? *

First Choice
Second Choice

d) Any respiratory or allergic disease, or any disorder of the stomach,bowel or gall bladder? *

First Choice
Second Choice

f) Any complaint or tendency that any necessitate such consultationor treatment in the future? *

First Choice
Second Choice

Are there any additional facts affecting the proposed insurance which shouldbe disclosed to insurers? *

First Choice
Second Choice

Have you any intention of engaging in winter sports or pastimes renderingyou liable to personal injury? *

First Choice
Second Choice

*are mandatory fields.

For Details, email: support@zoo.family | WhatsApp: +8801678569292