Reservation Form

Personal Contact Information

Name*		*required
Address
City
Country
Nationalty
Email*		*required
Passport Number
Expiration Date

Telephone	Country Code		City Code		Number

Reservation Information
Check-in Date
Check-out Date

Room Preference

Extra Bed

Number of rooms required

Number of people

Adult

Children

Transfer Service

Please meet me at:

Phuket Airport

Flight Number

Arrival Time

Arrival Date

Other (please describe below)

No thank you, I will arrive on my own.

Preferred Method of Payment:
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Please type any additional information or requests here:

Andaman Bangtao Bay Resort
82/9 Moo 3 Cherngtalay, Talang
Phuket 83110 Thailand
Phone:
(66) 076.270.246
(66) 076.314.291
Fax:
(66) 076.314.290
Mobile:
(66) 081.599.7899
Contact Person:
Khun Chatchai Prapaisilp
E-mail:
andamanb@loxinfo.co.th