First Name *				Last Name *
Middle Name				Gender		Male   Female
Company				Title
Address *
City *				State * Zip		Select from List Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Other
Email *				Home Phone *
Business Phone				Cell Phone
Fax Number				Occupation
Traveling With				Referred By

Type of Accommodation Desired
Twin Room (2 Beds)		Double Room (1 Bed)		Single Room
Smoking		Non-Smoking

Passport

Please submit copy of passport to: info@asiagetaway.com

For China visa information and download application form, please refer to www.chinaconsulatela.org or contact Ms. Patty So of Golden Star Travel at goldenstars.patty@gmail.com.

3% surcharge applies when payment settled by credit card.

Payment of the trip constitutes acceptance of the TERMS AND CONDITIONS as recited in the brochure or in more specific pre-tour passenger materials issued at the time of booking.

Comments/Questions