AJT for Asia Inquiry Form

Title Mr Mrs Ms Miss Title

First Name *

Middle Name

Last Name *

Yes, I am a travel agency

Street Address

Apt/Suite/Bldg

City

State/Region

Zip/Postal code

Country

Email address *

Re-confirm E-mail address *

Phone Number

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 Adults (12 & up)

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 Children with bed (3-11)

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 Children with no bed (3-7)

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 Infant/Toddler (0-2)

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Single Room(s)

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Twin Room(s)

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Double Room(s)

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Triple Room(s)

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Quad Room(s)

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Length of trip (in nights)

0 1 2 3 4 5 6 7 Flexibility (in nights)

Departure Date

Return Date

Select One Vacation Honeymoon Anniversary Visiting friends/relatives Business Other

Select One No breakfast Breakfast included in the hotel Breakfasts

Select One No lunch Some lunches All lunches Lunches

Select One No dinner Some dinners All dinners Dinners

South Korea
Vietnam
Myamar

Taiwan
Laos
India

Hong Kong
Cambodia
Indonesia

China
Thailand
Boneo

Select a Value Per Person: 500-1000 USD Per Person: 1000-1500 USD Per Person: 1500-2000 USD Per Person: 2000-2500 USD Per Person: 3000-4000 USD Per Person: 4000-5000 USD Per Person: 5000-6000 USD Per Person: 6000-7000 USD Per Person: 7000-8000 USD Per Person: 8000-9000 USD Per Person: 9000-10000 USD Per Person: 10000-12500 USD Per Person: 12500-15000 USD Per Person: 15000-20000 USD Per Person: Over 20000 USD per person for the entire land-tour package

Select one The above is my maximum budget I can increase up to 25% if needed Plan me the trip I want, don’t focus on the specific budget Is Budget Flexible?