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:
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)
