<% If Trim(Request.Form("cmd")) = "send" Then Dim objRsadd Set objRsadd = GetSQLRs("Select * From Registration Where ID Is Null") objRsadd.AddNew objRsadd("FirstName") = SafeRequest(Trim(Request.Form("FirstName")),0) objRsadd("MiddleName") = SafeRequest(Trim(Request.Form("MiddleName")),0) objRsadd("LastName") = SafeRequest(Trim(Request.Form("LastName")),0) objRsadd("HomeNumber") = SafeRequest(Trim(Request.Form("HomeNumber")),0) objRsadd("WorkNumber") = SafeRequest(Trim(Request.Form("WorkNumber")),0) objRsadd("FaxNumber") = SafeRequest(Trim(Request.Form("FaxNumber")),0) objRsadd("Email") = SafeRequest(Trim(Request.Form("Email")),0) objRsadd("Street") = SafeRequest(Trim(Request.Form("Street")),0) objRsadd("City") = SafeRequest(Trim(Request.Form("City")),0) objRsadd("State") = SafeRequest(Trim(Request.Form("State")),0) objRsadd("Zip") = SafeRequest(Trim(Request.Form("Zip")),0) objRsadd("TourName") = SafeRequest(Trim(Request.Form("TourName")),0) objRsadd("DepCity") = SafeRequest(Trim(Request.Form("DepCity")),0) objRsadd("DepDate") = SafeRequest(Trim(Request.Form("DepDate")),0) objRsadd("TFirstName") = SafeRequest(Trim(Request.Form("TFirstName")),0) objRsadd("TMiddleName") = SafeRequest(Trim(Request.Form("TMiddleName")),0) objRsadd("TLastName") = SafeRequest(Trim(Request.Form("TLastName")),0) objRsadd("TCitizenship") = SafeRequest(Trim(Request.Form("TCitizenship")),0) objRsadd("TPassportNo") = SafeRequest(Trim(Request.Form("TPassportNo")),0) objRsadd("TIssuePlace") = SafeRequest(Trim(Request.Form("TIssuePlace")),0) objRsadd("TIssueDate") = SafeRequest(Trim(Request.Form("TIssueDate")),0) objRsadd("TExpDate") = SafeRequest(Trim(Request.Form("TExpDate")),0) objRsadd("TDayBirth") = SafeRequest(Trim(Request.Form("TDayBirth")),0) objRsadd("TBirthPlace") = SafeRequest(Trim(Request.Form("TBirthPlace")),0) objRsadd("TEmergencyN") = SafeRequest(Trim(Request.Form("TEmergencyN")),0) objRsadd("TEmergency") = SafeRequest(Trim(Request.Form("TEmergency")),0) objRsadd("occupancy") = SafeRequest(Trim(Request.Form("occupancy")),0) objRsadd("Smoking") = SafeRequest(Trim(Request.Form("Smoking")),0) objRsadd("OtherRequest") = Htmlencode(Request.Form("OtherRequest")) objRsadd("AChain") = SafeRequest(Trim(Request.Form("AChain")),0) objRsadd("ARC") = SafeRequest(Trim(Request.Form("ARC")),0) objRsadd("AAgency") = SafeRequest(Trim(Request.Form("AAgency")),0) objRsadd.Update ClearObj(objRsadd) Call Alert("Your request has been successfully submitted.\nWe will contact you soon!","index.asp",0) End If %> Welcome to CIAC Travel, your full service travel agency offering the best deals!



Online Registration

Thank you for booking with China Travel Service. We also request a copy of your passport for purpose of making air reservations. Airlines request that the name on your ticket matches the name of your passport EXACTLY, including your middle name. If you do not give us a copy of your passport, and your ticket needs to be reissued later, you will be responsible for all change and /or cancellation fee.

Note: * = required
Contact Information

* First Name:
Middle Name:
* Last Name:
* Home Number:
Work Number:
 
Fax Number:
* Email Address:
 

Mailing Address
* Street
* City
* State
* Zip Code

Traveler Information
* Tour Name
* Departure City
* Departure Date

Traveler
* First Name:
Middle Name:
* Last Name:
* Citizenship:
* Passport No:
* Place of Issue:
* Issue Date:
* Expire Date:
* Date of Birth:
* Place of Birth:
* Emergency Contact Name:
* Emergency Contact Number:

Accommodation Request (check one)
Room(s) with Two Beds - Double Occupancy
Room(s) with One Double Bed (Subject to Availability) - Double Occupancy
Single Occupancy
Request Room Mate
Triple Occupancy

Additional Information*
Smoking
Non-Smoking
* Non-Smoking rooms cannot be guaranteed at all hotels in All cities

Please specify any other requirements (such as medical, dietary or personal requirements we should be aware of)
Also indicate specific extensions or add on services (hotel extensions, flight reservations, return stopovers, extension tours, etc).


*I have read CIAC Travel's Terms and Conditions and Understand that the deposit is non-refundable and that change and cancellation penalties apply.

For Travel Agent Use Only
Please specify if your agency a member of any chain or consortium
ARC Number
Please Enter Your Agency Name