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APPLICATION

Organization Name : ………………………...……………………………………………....

……….…………………………………………………………………

Government Private

Registered Business Address : ………………………...……………………………………………....

……….…………………………………………………………………

……….…………………………………………………………………

Organization e-mail : ………………………...……………………………………………....

Organization Objective : ………………………...……………………………………………....

Business Registration No (if any) : ………………………...……………………………………………....

Authorized Person Name : ………………………...……………………………………………....

Authorized Person Designation : ………………………...……………………………………………....

Telephone No : ……...................................... Mobile: ……….................................

E-mail : ………………………...……………………………………………....

Passport/NIC No : ………………………...……………………………………………....

Official Address : ………………………...……………………………………………....

……….…………………………………………………………………

……….…………………………………………………………………

GMR/SLR,
Please arrange to issue username and password for accessing Railway Passenger Registration System
on behalf of the Organization.

…………………………………………

Head of the Organization

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