Please complete, copy and email form to RICSABC@DRNEX.defence.gov.au

Alternatively, print and fax form to SABC at 011 61 2 4587 2929
To: SABC             From: AUSTAIR Washington
INFO: DEFAIR OCAF    SIC: WAQ/QFA

Subject: International OPPSAT - Request for travel on Flight No.

Personal Details of/Dependants only of (relevant only if dependants travelling alone):
Service Number: Rank/Title:
First Name: Last Name:

                                Army                 Navy                       Air Force                     
Details of all persons travelling as shown on passport (including members, if relevant):
Name (Last, First) Passport No. Nationality            DOB             Gender Relationship
Contact Details prior to departure:
Phone (W): Phone (H):
Address:
Overseas Contact Details (if known):
Street: City: State:
Zip Code: Country:
Phone (W): Phone (H):
Email:
Current OPPSAT Waitlist Numbers:
Flight(s) requested:
Flight Number Flight leg(s)
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