SAMRAN 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)
Telphone_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 Rooms Required : Type of Bed :
Number of rooms  required: Number of persons : Extra Bed Required Yes No
Airport Transfer Requires click here for more info.
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 :
Indicate here for any special request
Please take a moment to let us know from where you get to know our site:
  
To guarantee or 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

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

Samran Place Bangkok