(Please
print out, complete and mail this form)
China International Travel
Service Custom
Tour
China
and the Yangtze River Tour June 17-June 30, 2004
Enrollment Form
(PLEASE PRINT):
_______________________________________________________________________________
Last
Name
(as it appears on your passport), which will be used for your airline
ticket/s
________________________________________________________________ ____
First
Name
(as it appears on your passport), no nicknames please
M.I.
Title: Mr. q
Mrs. q Ms.
q
Sr. q
Dr. q
Bro. q
Rev. q
Prof.
Suffix: q
M.D. q
Ph.D. q
Jr. q
Other
________
Sex: Male q
Female Date Of Birth
_______ ____
______
Month Day
Year
Mailing
Address:
(Give specific street name and house number, not a PO box,
please)
|
Name: |
|
Street: |
|
City: |
State: |
ZipCode: |
Hm Phone: (____) _____________
|
Wk Phone: (____) ____________ |
Fax:
(____)
_____________ |
|
Cell:
(____) ____________ |
Email: ___________________ |
|
PAYMENT
INFORMATION:
Please indicate the amount being sent. $ _________________
(See
enclosed information for payment details)
MAKE
ALL CHECKS PAYABLE TO CITS USA
AND MAIL TO:
Rudy
& Maureen Wright
PO
Box 4152
Frankfort,
KY 40604
Your
Airline Departure City __________________________________________
Single
Room _______ ($635 single room
supplement fee)
Double
Room _______
Room
mate’s Name
__________________________________________________________________________
