Form

Lansing Regional Chamber of Commerce Registration
China Discovery & Connections Tour - October 16-25, 2012
REGISTRATION
Submit registration and copy of passport online. Send payment to Asia Getaway Inc. ǀ 7668 El Camino Real, Ste 104-618 ǀ San Diego, CA ǀ 92009
*Please input information exactly as it appears on your passport.
Upload passport:
Given names:
Surname:
Gender:

Male Female
Date of birth:
Month Day Year
Nationality:
Passport No:
Passport date of expiration: (mm/dd/yyyy)
Phone Number:
- Area Code Phone Number
E-mail:

Mailing Address:

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Company Name:
Title:
EMERGENCY CONTACT
Full name:
Relationship:
Phone Number
- Area Code Phone Number
E-mail (cannot be person traveling with you)
TRIP DETAILS
** Deadline for payment in full is August 16, 2012.
Tour Cost:

Single Occupancy Double Occupancy Visa Application Service ($195) Travel Insurance (additional fee apply. Submit travel insurance application form separately) Book your own air tickets to China (deduct $600 from the total cost)
Check for Optional Tours:

Beijing Hutong Tour ($32) Beijing The Legend of Kung Fu Show ($36) Acrobatic Show ($38) Xian day excursion ($685) Shanghai Maglev Train ($23)
Total:
Payment options:

Check *Checks are preferred form of payment. Please make payable to: Asia Getaway Inc. Credit Card (3% bank charge to be charge)
Additional Information
Hotel room:

2 Double Beds 1 King/Queen Roommate (input the name below) Match me with a roommate
Roommate Name:
Dietary Restrictions:

Vegetarian Gluten Free Diabetic Allergies (input type of allergies)
Type of allergies:
Airplane Seating Preference: (Seating is subject to airline availability and cannot be guaranteed)

Window Aisle Priority is to sit with travel partner
Name of travel partner:
Please list any additional info we should be aware of:
I have read and understand the responsibility, terms and conditions on this form:

Agree Disagree
Contact Iris Cheung at info@asiagetaway.com or 760-635-1288
Select “Print Form” before clicking “Submit Form.” Once form is submitted, it cannot be printed out.” A confirmation and an invoice will send to your email address above within 24 hours after submission.
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Lansing Regional Chamber of Commerce Registration

China Discovery & Connections Tour - October 16-25, 2012

REGISTRATION

Submit registration and copy of passport online. Send payment to Asia Getaway Inc. ǀ 7668 El Camino Real, Ste 104-618 ǀ San Diego, CA ǀ 92009

*Please input information exactly as it appears on your passport.

EMERGENCY CONTACT

TRIP DETAILS

** Deadline for payment in full is August 16, 2012.

Additional Information

Contact Iris Cheung at info@asiagetaway.com or 760-635-1288

Select “Print Form” before clicking “Submit Form.” Once form is submitted, it cannot be printed out.” A confirmation and an invoice will send to your email address above within 24 hours after submission.