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ONLINE BOOKING REQUEST FORM
Beijing Med • Beijing Med Tours
4225 Miller Road Ste#193 • Canton, MI 48188
Phone: 810/919-1285 • FAX 810/919-1285

o be part of these exciting journeys, reserve your space as early as possible. These are very limited space, small group adventures and filling up fast. Simply phone, email or fax us the full names of all those traveling in your party, and we’ll hold space for you. Remember that booking requests are subject to space availability at the time we receive your deposit. A deposit of $250 per person is required to confirm your space. Full payment is due 60 days prior to departure. For your convenience, you may print this form, then mail or fax it to Dr. Richard J. Hoder with your deposit or full payment. Make checks or money orders payable to Beijing Med Tours. Or, please fill out this form and submit it to us and we will contact you as soon as possible.

Thank you for joining us as we journey to China for good health.

Yes. Please reserve space for me as described below:

Departure Date
Itinerary	# 1: 8 days/7 nights Itinerary #2: 14 days/13 nights
Number of People Traveling in Party:
	Traveling Alone and looking for a share Prefer Single Accommodations
Name (1)
Name (2)
Name (3)
Name (4)
Contact Address
Street Address:
City:
State or Province:
Zip Code:

Time Zone:
Best Time To Call:
Daytime Phone:
FAX:
Email:
Specific Medical Concern for TCM
	Vegetarian Vegan Other Dietary Needs

If mailing in this form please complete the following:
	Deposit Enclosed $250.00 per person = _______________
	Or Full Payment in the Amount of _______________
	Check #_______________ Money Order _______________

Contact: Beijing-Med Tours Email: info@beijingmed.com
Or Write to: BEIJING-MED TOURS, 40576 Turnberry Court, Canton, MI 48188
Phone: 1-810-919-1285