Panviman Resort, Koh Chang

RESERVATION FORM
PERSONAL INFORMATION
IMPORTANT!! Pls furnish full name. Names furnished here will be the names used to register for the rooms.
Title Name : 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
1 Hour Transfer Service Required :
1.5 Hour Transfer Service Required :
5 Hour Transfer Service Required :
Number of Adults occupying room :
Number of Adults :
Number of Children ( if any ) :
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:



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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