MEKONG TRAVEL & TOUR

BOOKING FORM
PERSONAL INFORMATION
IMPORTANT!! Pls furnish full name. Names furnished here will be the names used to register for the rooms.
Title Name : First Name : Family Name :
IMPORTANT!! Pls furnish complete e-mail address so that our reply could reach you
E-mail Address :
( Correspondence E-mail address) *
E-mail Address : ( Second E-mail address, if any )
Fax No:
Telephone No :
Company Name (if applicable) :
Correspondence Address :
Country :
Nationality : *
RESERVATION DETAILS
Types of Package Tour Required:
Number of packages tour required:

Indicate here if more than 1 type of tours are required :

Tour to begin on : Pick up from which hotel :
FLIGHT INFORMATION
Flight Name and No. (Arrival) : Time of Arrival :
Flight Name and No.(Departure) : Time of Departure :
Indicate here for any special instruction for pick up, etc.


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