Khao Lak Palm Beach Resort
RESERVATION FORM
PERSONAL INFORMATION
IMPORTANT!!
Pls furnish full name. Names furnished here will be the names used to register for the rooms.
Title Name :
Mr.
Mrs.
Miss
First Name :
Family Name :
IMPORTANT!!
Pls furnish complete e-mail address so that our reply could reach you
E-mail Address :
*
( Correspondence E-mail address)
E-mail Address :
( Second E-mail address, if any )
Fax No:
Telephone No :
Company Name (if applicable) :
Correspondence Address :
Country :
Nationality :
*
RESERVATION DETAILS
Types of Promotion or Package:
Please Select
Stay 4 nights pay 3 nights
Stay 5 nights pay 4 nights
Stay 6 nights pay 4 nights
Stay 7 nights pay 5 nights
Stay 8 nights pay 6 nights
Stay 9 nights pay 6 nights
Stay 10 nights pay 7 nights
Stay 11 nights pay 8 nights
Stay 12 nights pay 8 nights
Stay 13 nights pay 9 nights
Stay 14 nights pay 10 nights
Stay 15 nights pay 10 nights
Stay 16 nights pay 11 nights
Stay 17 nights pay 12 nights
Stay 18 nights pay 12 nights
Stay 19 nights pay 13 nights
Stay 20 nights pay 14 nights
Stay 21 nights pay 14 nights
Types of Rooms Required:
Please Select
Deluxe Mountain
Deluxe Garden
Deluxe Seaview
Types of Bed:
Please Select
Single
Twin
Double
Triple
Number of Rooms Required:
1
2
3
4
5
6
Number of Adults occupying room :
Extra Bed ( if required ) :
Yes
No
Number of Children ( if any ) :
0
1
2
3
4
5
Age of Children :
Indicate here if more than 1 type of rooms are required. Please also furnish names of the guests for the additional rooms
Indicate here for any special request ( bed types preferred, connecting room, etc.)
Date of Check In :
Date of Check Out:
FLIGHT INFORMATION
Flight Name and No. (Arrival) :
Time of Arrival :
Flight Name and No.(Departure) :
Time of Departure :
Please indicate if airport pick up Service is required :
Yes
No
Please take a moment to let us know from where you get to know our site:
Please select one of the followings:
From search engine directly to our site
From search engine to Asia Travel
From other web site
From printed media
From friend's recommendation
If you encounter any returned e-mail OR difficulties sending your booking details through this form, you may send your booking details to our help desk at our main reservation office at e-mail address
help@asiatravel.com
At your services always !
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