Do I need my hotel booking when applying for tourist visa?

I am going to Shanxi province on the 16th Sept.2014 applying for a L type. I have my round trip air tickets. I am going there for an International Operation Smile Medical Mission for 11 days only. I can provide an invitation letter from PRC. Can I apply without the hotel booking. Anyway the Operational Smile in China has not sent us the hotel booking. But it will come before I depart for PRC. This is my third time to come to PRC for this medical mission.

Ask by W.B.Leung UK