First Name In your Passport:  

Last Name in Your Passport: 
( * To guarantee your check in,  it must be SAME AS  the name in your passport. 
Or maybe you can't check in according to the reservation we have done for you. )

Nationality/Country (as in Passport): --Please Select--AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegowinaBotswanaBouvet IslandBrazilBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote D'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong Kong SAR, PRCHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiD.P.R. KoreaKoreaKuwaitKyrgyzstanLao People's RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint Kitts and NevisSaint LuciaSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSt HelenaSt Pierre and MiquelonSudanSurinameSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwan RegionTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuelaViet NamVirgin Islands (British)Virgin Islands (US)Wallis and Futuna IslandsYugoslaviaYemenZaireZambiaZimbabweOther-Not Shown ( * Required )

E-Mail Address:  ( * Required Please check carefully!)

Alternate E-mail Address:  ( * ( * Required Please check carefully! ))

Your Phone Number (including extension):  (We can easily call you )

Your Fax Number:  ( if possible)

1st  Hotel of Your Choice:  ( * Required )

2nd Choice Hotel (if the first hotel is fully booked, where would you like to stay?)

Type of Rooms: Standard, Superior, Deluxe, Suite, 
or other room type of Rooms: ( * Required )

Type Of Bed:  One Single Bed, Two Single Beds, One Double  or king Bed Triple Beds.

2nd Choice Room Type: , If the type of room is fully occupied, would you like to stay other room type?

City location of the Hotel: 

Arrival Date:  ( * Required )

Departure Date:  ( * Required )

Number of Nights:  Number of Rooms:  ( * Required )

Number of Adults:  ( * Required )

Would you like to attend the one day Xi'an Local tour: Tour line: , Tour day: 

Arriving Time (please provide the detail e.g. Flight Number, Train Number. 
Some hotel's  room in peaking will be held till 6pm if you haven't the arriving time:

   ( if possible)

Confirm to reserve the hotel            Just inquiry 

Special Request (Please type in the box below):

We appreciate it if you could let us know how did you find our website?  

If you can't submit the form, you can print the page fax to us: 0086-10-691891904  or save the page and email to us at: wypbj@yahoo.com , You may also send your order to us from  hotel@chinadiscounthotel.com  directly.