LIPA LOVELY RESORT BOOKING FORM
 
Date of check in     Day       Month     Year 
Date of check out   Day       Month  
 
 Type of accommodation preferred    Number of rooms
Number of adults            Number of children under 12                
 
 e.mail address you would like us to reply to      
Mr/Miss/etc    Full Name   
Telephone Number  including country code                      
 
Specify any other requirements below. Please include extra bed or cot if needed .
 
Do you require collection from the airport?     yes      no       
 
 
 
If your request is not covered here or if you have a problem with the form please e.mail me at bjsamui@btinternet.com