Traveler Information
June 2016 Trade Mission to China, Japan & Taiwan
Please complete the following and return to Joseph Rude ([email protected]) or fax to 515-7253010. If there is more than one person from your company/organization participating on this mission,
or if you are traveling with a companion, please fill out a sheet for each person.
Delegate Name:
Position / Title:
Company/Organization Name:
Complete mailing address:
Phone:
Fax:
Mobile:
International Mobile:
E-mail:
1. Hotel room request.
Sat, June 11 – Xi’an
Sun, June 12 – Xi’an
Mon, June 13 – Xi’an
Tue, June 14 – Chongqing
Wed, June 15 – Chongqing
Thu, June 16 – Tokyo
Fri, June 17 – Tokyo
Sat, June 18 – Tokyo
Sun, June 19 – Taipei
Mon, June 20 – Taipei
Tue, June 21 – Taipei
Other (please list)
Single:
Double for single occupancy:
Double for double occupancy:
sharing a room with:
Smoking:
Non-smoking:
2. Credit card number to secure your hotel room- no charges will be applied to your card. You will be
responsible for all hotel expenses at check-out.
Type: VISA
Number: XXXX XXXX XXXX XXXX
Expiration Date: MM / YY
3. Intercity transportation request
Tue, June 14 – Flight from Xi’an to Chongqing
Thu, June 16 – Flight from Chongqing to Tokyo
Sun, June 19 – Flight from Tokyo to Taiwan
4. Tickets to Food Taipei Trade Event (this is not part of the official trade mission, but IEDA will provide
limited support)
June 22 – 25
4. Passport Information
Name (as it appears on your passport):
Birth date:
Date of Expiry:
Passport Number:
Do you have China entry visa? No
Country of Citizenship:
Yes
4. List a person in the United States to contact in case of emergency.
Include name, relationship, address and day, evening and mobile phone numbers.
5. Please list any dietary restrictions that may require special meals while on the mission.
6. Do you have any health or mobility restrictions of which the mission organizers should be aware?
No
Yes
If yes, please list
(Please carry all prescription medication on the plane with you and in the containers in which they were
prescribed.)
7. Is there any other information the organizers should be aware of to make your participation more
comfortable?
No
Yes
If yes, please list