First                              Last

Name of Sponsor :

Postal Address :__

email address : __

Country :_______

Pledged Contribution

Currency :_________

Amount Submitted :_

Date of transfer :___

Sponsors will receive the PAHUNCH free of charge for the duration of their support

Please be so kind to pay your contribution into the following bank account, clearly stating your name and postal address:

Account holder's Name    : Nepal Trail Bridge Forum

Bankers Name                : Nepal Investment Bank Ltd.

Address                        : Branch Office, Pulchowk, Lalitpur.

Account No.                  : 73 44 700

Swift Code                    : NBL NP KT