| Date:
Our
Bef .
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| Expedition
No.
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| Expedition Name:
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| Expedition Time:
Month Date
Year
|
| List of Participants:
|
| Full
Name |
Occupation |
Male or Female |
Passport
No.
|
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| Applicant Name & Address : (To whom all correspondence will be
sent, including the invitation letters from Chinese Academy of Science for your visa to
China) |
| First Name:
Surname:
|
| Position :
|
Male or Female: |
Passport No. |
| University / Institution: |
| Street address:
|
| City:
State:
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| Zip/Postal code:
Country:
|
| Phone:
Fax:
|
| E-mail:
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| Special Requirements for your Travel (Single Room, Visit Institutions
or Universities etc): |
|
Terms
of Payment:
(All
the payments should be made 4 weeks before the expedition start date. )
[
]
Electronic
Transfer
[
]
Travel
Cheque
[
] Cash
(USD, GBP, EURO) are
acceptable.
|
[
]
Credit
Card
Card Type:
[
] Visa
[
] Mastercard
[
]
American
Express
|
|
Card
Number
|
|
Name
of Card Holder (as printed on the Card)
|
|
Expiration
Date:
Signature:
|
Confirmation & Visa: After we received your
application / Reservation form, a confirm letter will be sent to you by E mail shortly. An
original invitation letter from the Host Institution (Chinese Academy of
Science ) then will be sent to you by post.
And we'll keep contact with you to make sure the proper arrangements for your expedition.
Privacy policy: This reservation service
is free. All your information will be kept confidential.
|
Please
fill this form and fax or E mail it to :
100GoGo Head Office,
45 Oaklands, Westham, Pevense, Eastbourne,
East Sussex, BN24 5AW, UK
E mail: expedition@100gogo.com
Fax: (44) 1323 763517 |