The Elephant Crossing Hotel, Vang Vieng, Laos PDR

RESERVATION FORM

Please fill out the form below to inquire about room availability. Our staff will reply to you within 24 working hours.(Please note that any reservations will be subject to room availability.)

Please fill in the required fields marked with *.

First Name:*		Last Name:*
Email:*
Phone:*		Fax:
Number of Guests:*

Room Type:*	No.# of rooms:*	Check-in Date:*	Check-out Date:*	Total in USD





Sub Total:
4% Service Charge:
Grand Total:

Coming From:
Arrival Time:

Please provide additional information/comments/questions here:

In order to secure my travel services, I authorize The Elephant Crossing Hotel to charge my Credit Card,
the number of which and amount are stated below:

Name of your bank as issue the card:

Cardholder's name:

Date of Birth: (DD/MM/YYYY)

Passport No.: Country:

Type of Card:

Card Number:

Expiration Date: (MM/YY or MM/YYYY)

Amount in USD:

CVV2/CVC2: (Last 3 Italic digit back card)

**Please note that room rates are subject to change without notice. You will be notified of changes in your booking confirmation by email prior to any reservations are made in your name. The transaction for payment via visa will be made on confirmation of the booking and is NOT REFUNDABLE.**

www.theelephantcrossinghotel.com, Email: info@theelephantcrossinghotel.com