Room Type Bungalow Superior Suite Type of Bed Single Twin Extra Bed Double Number of Rooms 1 2 3 4 5 6 7 8 9 10 Number of Persons 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Arrival Date Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month January February March April May June July August September October November December Year 2005 2006 2007 Departure Date Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month January February March April May June July August September October November December Year 2005 2006 2007 Flight Numbers Arrival   Departure  First Name * Family Name * E-mail Address * Address Country Telephone Fax Additional Requirements (Airport Transfer, Extra Bed etc.) Card Details To guarantee your reservation we ask that you pay the first nights accommodation. Thai law states that we must have your signature to debit any amount. When you submit this form a new text version will be generated for you to print, sign and fax. All further correspondence will be via email using the address you supply above. If you wish to cancel, you must do so at least 7 days before the planned arrival date, if not PhuketOrchid Resort  has the right to deduct one night accommodation from your credit card. Card Type Visa Master Card Amex Diners JCB Card Number Expiry Date   * Important: required fields to process your booking