Customer Name*   Prefix*
Company Name
Rebate Code
Telephone No.(1)*
Telephone No.(2)
Fax No.
Email Address*
Delivery Address*
  (Commercial and Industrial Districts Only)
Customer Survey
 1) Through what channel you learn about iNet?*
 2) Where do you normally get travel information?*
 3) What kind of promotional offer do you like the most?*
 4) Where will be your travel destinations in the next 12 months?(you can choose multiple)*
Japan Korea Taiwan Malaysia Europe USA Africa
Australia/New Zealand Middle East Other Asia Countries Cruise
Others (Please provide specific destinations below)
*Required fields