Phuket Packages, Thailand - Reservations Form

PERSONAL INFORMATION :
Important !!! Please furnish full name. (Title / First Name / Last Name)
1st Passenger Name :
 *
2nd Passenger Name :
3rd Passenger Name :
Important !!! Please 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 :
Correspondence Address :
Country :
Nationality : *

RESERVATION / BOOKING INFORMATION :
1st choice of hotel : *
2nd choice of hotel : *
Choice of Sight-seeing tour : *
Optional tours :
Types of bed :
Number of rooms required : *
Extra bed : Yes No
Number of person (adult)s : *
Number of children (if any) :
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 : ( i.e. January 1, 2005 )
Date of check out : ( i.e. January 1, 2005 )
Preferred payment method :

FLIGHT INFORMATION :
Roundtrip air ticket from Bangkok-Phuket-Bangkok by Orient Thai (Economy Class)
Bangkok-Phuket :
Phuket-Bangkok :
Remark : * Required Information


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 contact@e-biz-travel.com

At your services always !
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