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 :
Renter's Age :

RESERVATION DETAILS
Name of Hotel Required :	Please Select Burasari Resort Katathani Phuket Beach Hotel Millennium Resort Patong Thara Patong Beach Resort & Spa Tropical Garden Resort
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 for any special request ( bed types preferred, connecting room, etc.)
Self Drive Information :
Pickup Date :		Arr. Flight Number :
Drop-off Date :		Dep. Flight Number :
Pick-up location in Thailand :
Drop-off location in Thailand :
Driving License No. :		Expiry Date :
No. of people travelling :
Indicate here for any special request ( Baby Seat, Street Directory, etc.)
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