Hotel Reservation Form
13th Bangkok Symposium on HIV Medicine 2010 at QSNCC
Period 20-22 January 2010

Guest Information
Title :
Last Name :
First Name :
Company :
Nationality :
E-mail :
Mobile :
Booking Information
Check-in Date :
Nights :
Adult :
Children :
Room Type : Grand Deluxe at Garden Wing for Thai Resident only.
 

- Single ( 1,200 Baht / night / included ABF) More detail

  Grand Deluxe - Twin (1,400 Baht / night / included ABF ) More detail
   
Room Type : Counsellor Suites at Suite Wing for Overseas guest or Thai Resident.
  Counsellor Suites - Single (2,500 Baht / night / included ABF / free internet ) More detail
  Counsellor Suites - Twin (2,800 Baht / night / included ABF / free internet ) More detail
   
  Price are inclusive of 7% VAT and 10% Service Charge
Smoking :
 No
  Yes
 
( Subject to availability )
Other requirement :
Credit Card Information
Credit Card
Number :
Expiry Date :
Flight Information
Arrival :
Flight Name and no. : Time of Arrival :
Departure :
Flight Name and no. : Time of Departure :
 Please indicate if airport pick up service is required :
   
   
 Terms and Conditions
* Cancellation / No show : one night charge from the credit card guarantee and non-refundable in any case.
   

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