EVERGREEN PLACE, BANGKOK
RESERVATION FORM
PERSONAL INFORMATION
Mr. Mrs. Miss
First Name : Last Name :
Email_Address 1: Correspondence E-mail address *required
Email-Address 2 : Second e-mail address, if any or Reconfirm
Telephone_number : Fax_number :
Company Name (if applicable) :
Country : Nationality :
Important!! Pls furnish complete email address so that our reply could reach you
RESERVATION DETAILS
Types of room(s) Required : *required
Number of room(s) required : Number of Person(s) required : Extra Bed : Yes No
Number of Children under 12 years : 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
Date of check in : Date of check out:
FLIGHT INFORMATION
Arrival Flight name and no. : Time of Arrival :
Departure Flight name and no. : Time of Departure :
Airport Transfer Request: click here for more info.
Indicate here for any special request
Please take a moment to let us know from where you get to know our site:
To confirm 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
Remark:

Your credit card information is required to secure your reservation then payment will be charged after your reservation is confirmed..
For further information please contact us at e-mail : rsvn@asianetonline.com

Evergreen Place