Reservation Information
Firstname:
Mr.
Mrs.
Ms.
Lastname:
Nationality:
*Required!
Email Address :
*Required!
Address:
City:
Country:
Telephone No :
Fax No :
Passport number:
*Required!
Reservation Details
Types of Rooms Required :
**REGULAR ROOMS**
Superior
Deluxe
**SUITES**
1 Bedroom
2 Bedrooms
3 Bedrooms
Number of Rooms Needed:
1
2
3
4
5
6
Occupants per room:
Adults
Children
eg. 2 (person)
Age of children
eg. 5, 7 (years)
Extra bed:
yes
no
Date of check in :
Date
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Year
2003
2004
2005
Date of check out :
Date
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Year
2003
2004
2005
Please fill in guest info
1st Room Info
Lastname
Middlename
Firstname
Age
1
Mr.
Mrs.
Ms.
2
Mr.
Mrs.
Ms.
3
Mr.
Mrs.
Ms.
2nd Room Info
Lastname
Middlename
Firstname
Age
1
Mr.
Mrs.
Ms.
2
Mr.
Mrs.
Ms.
3
Mr.
Mrs.
Ms.
3nd Room Info
Lastname
Middlename
Firstname
Age
1
Mr.
Mrs.
Ms.
2
Mr.
Mrs.
Ms.
3
Mr.
Mrs.
Ms.
Flight Information
Arrival flight no. :
Date/Time of Arrival :
d /m/y
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
hr
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
min
Departure Flight no. :
Date/Time of departure:
d/m/y
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
hr
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
min
Other Requirement:
Place here any special request eg: connecting rooms, no smoking, etc.
If you have any difficulties in sending your booking details with this form, you may also send your booking details to our reservation office at :
pinewood@loxinfo.co.th
