Potalai Bangkok
Spa Package Booking Form

 Booking Information

Guest Name :
Email Address : Important!!
Nationality :
Address :
Telephone No :
Fax No :


  Booking Details

Types of Package Required :
Number of Adult :
Number of Children
(Under 12 years old) :
(If any)
Tour to begin on date :
Preferred start time :
At which hotel are you staying :
Would you wish us to arrange transfer :
If yes, our staff will confirm with price.

Indicate here for any special instruction :

  Credit Card Details

Please debit :    
Against Credit Card :
Credit Card No :
Cardholder Name : 
Expiry Date : /  

Please advise the last three-digit number or four digit number (for AMEX) appearing on signature panel (if any) : (See example)

Bank issuer
(Bank's Name) :

If you encounter any difficulties sending your booking details through this form, you may send your booking details to our reservation center or call us at (662) 502 0752 during our office hours.


Potalai - Thailand Spa Collection