Jack Lim's Relaxation Music

Jack Lim China Qigong Study Tour Booking Form

June 10-29 2006
Press the Print button on your browser to print the following booking form:
(Please book now to ensure your place)

Please reserve ___ places on the 2006 Jack Lim Qigong Tibet Tour. I forward a non- refundable deposit of $200 (per person). Cheques written to Jiangsu China Travel Service. Overseas/interstate members US$200.

Cash Cheque Visa M/card B/card

Card no.   

Expiry Date ____/____ Name on Card ___________________________

Signature ______________________________ Date _______________

Name (as on Passport) ____________________________ Email__________________________

Phone No. (H)_______________________ (B)_______________________

(M) _______________________ Fax_______________________

Address _______________________________________________________________________

__________________________________________________________ Post Code ___________

Nationality (as per Passport) ______________________ Passport No______________________

Expiry date ______________ Issue date_____________ Place of issue ______________________

Visa No (later)_____________________ Visa category( later)__________________________

Next of Kin: Name________________________________________________________________

Next of Kin: Address______________________________________________________________


Next of Kin: Phone______________________________

Send or fax the completed form to Jack Lim: 458 Whitehorse Road, Surrey Hills 3127 Vic Australia.
Phone/Fax (03) 9836 6961 (please phone before faxing)

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Copyright 2005 Jack Lim Productions