TOPLAND Hotel Phitsanulok
RESERVATION FORM *Special prepaid rates

PERSONAL INFORMATION
Mr. Mrs. Miss
First Name: * required
Last Name: * required
Email Address: **required
Telephone Number: Fax Number :
Company Name
(if applicable) :
Nationality: (as in Passport)
Country of Residence: (Where are you now?)
Important!! Please furnish complete email address so that our reply could reach you
RESERVATION DETAILS
Types of rooms required :
Types of bed required :
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 check in Date check out
FLIGHT INFORMATION
Arrival Flight name and no. : Time of Arrival :
Departure Flight name and no. : Time of Departure :
Indicate here for any special request
Please take a moment to let us know from where you get to know our site:
To payment your reservation, please print out this form and fill in all the information required with your signature and fax this form to (66 2) 541-9574

Remark: You will be informed of the status of your reservation within 24 hours after this form has been submitted. Thank you and we wish you a pleasant journey.
For further information please contact us at e-mail : rsvn@asianetonline.com
TOPLAND Phitsanulok