Jack Lim's Relaxation Music

Jack Lim China Qigong Study Tour Booking Form


April 28 - May 16 2009

Press the Print button on your browser to print the following booking form:
(Overseas participants are welcome to join - please contact Jack for more information)

Please reserve ___ tickets for,

Your Name/s _______________________________________________________

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______________________________

If sent to Jiangsu China Travel, please send a copy to Deborah Jonston, 161 Canterbury Rd, Toorak VIC 3142.

Enquiries about the itinerary please contact Jack Lim.

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