Booking Form -

Burma-Thailand Railway

Please complete the form below. If you have any queries, email hwt@historicwartours.com.au .

Preferred Departure Date ex Bangkok

Person (Primary) #1

First, Middle & Last Name as per Passport

Mobile Number

Passport Number

Nationality of Passport

Address

Post Code

State

CENTRAL BANGKOK PICK-UP/DROP-OFF HOTEL

Pick-up Hotel

Drop-off Hotel

Please add "as above" if same as the pick-up hotel

OTHER INFORMATION

How did you hear about us?

Group Special Requirements

Person #2

First, Middle & Last Name as per Passport

Passport Number

Nationality of Passport

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