First Name      : Mr. Mrs. Miss	Last Name       :
Passport No.   :	Nationality       :
Country           :
Correspondence Address
	Telephone No.  :
	Fax No.             :
	E-mail                :
RESERVATION DETAILS
Room Type               : - Please Select - Seaview Bungalow Standard Bungalow Connecting Bungalow	No. of Room(s)      :
Bed  Type                 : - Please Select - Double Bed Twin Bed	Extra Bed              : YES        NO
No. of  Person(s)      :	No. of  Adult(s)      :
No. of Children(s)    :	Age of Children     :
Indicate here if more than 1 type of rooms are
required, please also furnish names of the	Indicate here for any special request.
guests for the additional rooms
Check In Date         : DD 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 MM 01 02 03 04 05 06 07 08 09 10 11 12 YY 02 03 04 05 06	Check Out Date : DD 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 MM 01 02 03 04 05 06 07 08 09 10 11 12 YY 02 03 04 05 06
Airport pick up service       : YES        NO
Flight Name and No. of Arrival    : Time of Arrival      :
Flight Name and No.of Departure: Time of Departure:
Boat transfer to and from Koh Mook    : YES        NO
Where you get to know our site ?          : - Please Select - Search engine directly to our site Link of other website Printed media From friend's recommendation
Please be advised that we will confirm your room only after a signed reservation form
and 1 night deposit is received.