AS -- Expatriate Assistance Program (AS -- EAP)

AS-EAP VIP Family Membership Application & Agreement

Member's Demographics Member's Name Spouse's Name Children's Name (Please list all) Member's Address including Zip Code Primary Phone Number (Recommend Cellular phone but please include city code for land line) Other Phone (Home/Work/Cellular/ChinaHelpLine submission) Other Phone (Home/Work/Cellular/ChinaHelpLine submission) Other Phone (Home/Work/Cellular/ChinaHelpLine submission) E-Mail Address Services Interested Please check ALL services that you like us to sign up for you Please Choose No Thanks (Call if Change Mind) Permission Granted for Checked Service Below China Help Line Enjoy Best of Shanghai Terms and Conditions Have you read and agreed to the Term and Conditions of the Membership Agreement? Yes No (Your application will not be processed)

Terms and Conditions

1. All AS-EAP VIP Membership are for one year in duration.

2. An active AS-EAP VIP Membership is required to receive any discounts.

3. AS-EAP Housekeeping Membership is excluded from all no-charge promotional AS-EAP VIP Membership.

4. ASHRCM, Ltd. reserves the right to modify AS-EAP VIP Membership at anytime without advanced notice.