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 Promotions or Packages:	Please Select Muang Pai Excursion Package
Types of Rooms Required:	Please Select Deluxe Cottage
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
Preferred payment method: Pls select By Visa Card By Master Card By JCB Card By AMEX By Telegraphic Transfer
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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