PLEASE FILL IN YOUR BOOKING FORM Guest Information: * First Name: * Last Name: * Email Addres: Arrival Information: * Arrival Date: Month: Day: Year: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 25 26 27 28 29 30 31 2009 2010 2011 * Arrival Time: Hour: Minute: AM/PM: 01 02 03 04 05 06 07 08 09 10 11 12 00 05 10 15 20 25 30 35 40 45 50 55 AM PM * Arrival by: *Bus Company/Fligh No: * Request pickup: PLAN BOAT BUS NO YES Please select room booking Detail: * Room Type: *No.of Rooms *No.of nights Single Share Bathroom (3.00 USD) 0 01 Room 02 Rooms 03 Rooms 04 Rooms 05 Rooms 0 01 night 02 nights 03 nights 04 nights 05 nights 06 nights 07 nights Double Share Bathroom (4.00 USD) 0 01 Room 02 Rooms 03 Rooms 04 Rooms 05 Rooms 0 01 night 02 nights 03 nights 04 nights 05 nights 06 nights 07 nights Single Private Bathroom (5.00 USD) 0 01 Room 02 Rooms 03 Rooms 04 Rooms 05 Rooms 0 01 night 02 nights 03 nights 04 nights 05 nights 06 nights 07 nights Double Private Bathroom (6.00 USD) 0 01 Room 02 Rooms 03 Rooms 04 Rooms 05 Rooms 0 01 night 02 nights 03 nights 04 nights 05 nights 06 nights 07 nights Single Private Bathroom with TV (7.00 USD) 0 01 Room 02 Rooms 03 Rooms 04 Rooms 05 Rooms 0 01 night 02 nights 03 nights 04 nights 05 nights 06 nights 07 nights Double Private Bathroom with TV (8.00 USD) 0 01 Room 02 Rooms 03 Rooms 04 Rooms 05 Rooms 0 01 night 02 nights 03 nights 04 nights 05 nights 06 nights 07 nights Single Private Bathroom with TV, A/C and Hot Water (13.00 USD) 0 01 Room 02 Rooms 03 Rooms 04 Rooms 05 Rooms 0 01 night 02 nights 03 nights 04 nights 05 nights 06 nights 07 nights Double Private Bathroom with TV, A/C and Hot Water (14.00 USD) 0 01 Room 02 Rooms 03 Rooms 04 Rooms 05 Rooms 0 01 night 02 nights 03 nights 04 nights 05 nights 06 nights 07 nights ________________________________________________________ © 2006 by Popular Guest House Address: #033, group 10, Viheachin Village, Svaydangkum commune, Siem Reap District, Siem Reap province, Cambodia. Tel : (855) 12 916165 Email: vunchum@gmail.com