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Last Name

First Name

Full Name as in the Passport

Passport No.

Date of Birth (dd/mm/yy)

Date of Issuance

Country of Birth

Date of Expiration

Citizenship

Int¡¯l Flight to Beijing

Arriving Date (dd/mm)

Flight No.

Arriving Time

Int¡¯l Flight from Beijing

Leaving Date (dd/mm)

Flight No.

Leaving Time

Diaoyutai State Guesthouse Check-in Date

Diaoyutai State Guesthouse Check-out Date

Mailing Address for Receiving Air Tickets

(Street)

(City)

(Country)

Topic of Speech

Interested Panel

1. Strategy

2. Research

(Details see Agenda)

Language to be used in Keynote Speech (for Simultaneous Interpretation)

Preferred Language for Chinese Assistant