D'MA PAVILION BANGKOK HOTEL
RESERVATION FORM

PERSONAL INFORMATION
Mr. Mrs. Miss
Guest-Name :
Email_Address 1: ( Correspondence E-mail address ) *required
Email-Address 2 : ( Second e-mail address, if any or ) *Reconfirm
Telephone number : Fax :
Company Name (if applicable) :
Country : Nationality :
Important!! Pls furnish complete email address so that our reply could reach you
RESERVATION DETAILS
Types of Rooms Required: Type of Bed :
Number of rooms required: Number of persons required:
Number of Child: Ages of Children: Extra Bed Required Yes No
Indicate here if more than 1 type of rooms are required
Please also furnish names of the guests for the additional rooms
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 :
Airport Transfer required : No Yes
Indicate here for any special request
Please take a moment to let us know from where you get to know our site:
To guarantee your reservation, please print out this form and fill in all the information required with your signature and fax this form to +662 541-9574
If you encounter any return email 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 email address rsvn@asianetonline.com
D'Ma Pavilion