Easy China Visa Order Form

7001 Corporate Drive, STE. 308

Houston, TX 77036

Toll Free 1-866-641-4298

I. Departure Date: II. Need Passport/Visa Back Date:

III. Contact Information: Name:

Phone: Email:

IV. Name of Applicant(s):

First Name Last Name Passport Number

V. Visa Service Requested:

Visa Type: Tourist Business Student Work Crew

Authentication

Number of Entries: Single Double Multiple

Processing Time: Regular Express Rush

VI. Processing Fees:

Consular Fee: Service Fee:

FedEx Return: Total Fee:

VII. Payment Information:

Payment Method: Check Money Order Visa Master Card

Credit Card #: Expiration Date:

Card Holder Name:

Billing Address:

Signature:

* Credit card payment subject to a charge of 3% processing fee.

VIII. Shipping Information:

Name: Phone Number:

Company (if applicable):

Street:

City: State: Zip Code:

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