Personal Details ( * Required )
   
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!! Pls furnish complete email address so that our reply could reach you !!!
Booking Details ( * Required )
   
Date check in
Date check out
Types of rooms  required
    
Type of Bed
  
  No.of rooms required:
No.of persons required:
   
No.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

Flight Details
Airport Transfer Required
 Yes No
Flight name & no.(Arrival)
   Time of Arrival
Flight name & no.(Departure)
Time of Departure 

click to credit card form of hotels bangkok thailand 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 3871-3309

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 info@piyadapattaya.com
  

Copy Right 2004. Address : Piyada Residence Service Apartment Pattaya
390 /23 M.10 Pattaya 3Rd., South Pattaya, Pattaya,Chonburi,THAILAND 20150
Tel : (66) 038 - 713316 Fax : (66) 038 - 713309 E-mail : info@piyadapattaya.com