Reservation Form_Medical Association of Thailand in June 2022
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The International Code of Medical Ethics (ICoME)
during June 6-8 June 2022
Hotel Reservation Form Attn: Ms. Nattakarn Thepnarong
Please complete this form and fax/email Centara Grand At Central Plaza Ladprao Bangkok
A hotel confirmation letter will be sent to you 1695 Phaholyothin Road, Chatuchak
within 3 working days on your confirmation. Bangkok 10900 Thailand
Tel : 662 5411234 Ext 4409
Fax. 662 5411089/Email: nattakarnth@chr.co.th
Last Name :_____________________________ First Name :__________________________
Middle Name :____________________
Company Name:________________________________________________________________ Title:____________________________
Address: _____________________________________________________________ Country:_________________________
E-mail: ___________________________ Tel:_________________________________
Fax:_____________________________
ID card/or Passport Details:
ID/Passport Number:__________________________________
Date of Issue:_____________________________________________________
Place of Issue:________________________ Expiry Date:_______________________________________________________
Booking Details:
Check-in Date:________________________ Arrival Flight:_______________________ Time:____________________________
Check-out Date:_______________________ Departure Flight:____________________ Time:____________________________
Single Twin Number of room (s)
□ THB 2,400 Net □ THB 2,800 Net __________
□ THB 3,200 Net □ THB 3,600 Net __________
□ THB 4,900 Net □ THB 5,300 Net __________
*Included Breakfast, Internet access
Preference: Smoking Non-smoking Other…………
– The above room rates are Net inclusive of 10% Service Charge and 7% VAT
– All reservations must be accompanied by credit card to ” Centara Grand At Central Plaza Ladprao Bangkok ” as guarantee booking.
– Check-in time is 03:00PM. Guarantee early check-in will be charged one more night, Check-out time is 12 noon.
– Extended use of rooms till 6.00 pm on day of departure is subject to half day’s rate. Thereafter, a full day’s room rate
will applicable.
– Cancellation made after 1 June 2022 fully charge for whole period will be applied.
Airport Pick Up ( Suvarnabhumi Airport)
– Airport transfers by rental car can be arraned as long as the flight details are provided, with an additional cost.
Airport to Hotel Baht 2,400 Net/Car/Way Hotel to Airport Baht 2,400 Net/Car/Way
Airport to Hotel Baht 2,600 Net/Van/Way Hotel to Airport Baht 2,600 Net/Van/Way
Reservation is required within 25 May 2022
PAYMENT
Credit Card Details / Card Company : □ Visa □ Master Card □ Amex □ Diners □ JCB □ Others
Credit Card Number: Expiry Date: ___________________________
Cardholder’s Name:
For Centara Grand At Central Plaza Ladprao Bangkok
Confirmed by:______________________________
Booking/Confirmation Number : ______________________
Date :____________________________________
TERM AND CONDITIONS
Accommodation at Centara Grand at Central Plaza Ladprao Bangkok
RESERVATION DETAILS
BOOKING (tick choice)
Room Type
Deluxe Room ( 35 sq.m)
Deluxe Suite Room ( 45 sq.m)
Premium Deluxe Suite Room
( 52 sq.m)