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PERSONAL INFORMATION
Mr. Mrs. Miss
First Name:       
Last Name:       
Email Address 1:     **required
Email Address 2:     **required if any
Telphone 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

Please select the hotel and room type you would like to reserve.

Types of rooms  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
Number of Days
Flight detail (Arrival)            Time of Arrival : 
Flight detail (Departure)          Time of Dep.:   
Limousine Service Request    Yes    No
Security Code : captcha

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 rsvn@nisacabanakohchang.com


 
© 2007  Nisa Cabana Koh Chang  All Rights Reserved.                         
Nisa Cabana Koh Chang ResortTrat 113 Moo 1, Koh Chang Tai, Koh Chang, 23170 Thailand      
Site Office 
Tel : +66 (0) 3955 8161 Fax : +66 (0) 3955 8164  Email : info@nisacabanakohchang.com
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