Online Booking Form

Please read through this form carefully before completing it with the information required. If you have any questions about this form, please contact [email protected].

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Contact & Passport Information

(Note: Visa to Vietnam is compulsory, visa to Myanmar compulsory, visa to Cambodia & Laos can be made upon arrival to the airport)

Mailing address

Phone (business)

Phone (home)

Fax

Email (*)

Name of Emergency Contact

Relation

Phone

Trip Information

Trip Name

Trip Code (If any)

Trip Date

Contact Person

Accommodations

I will share a double room (1 big bed)
I will share a twin room (2 single beds)
I prefer single accommodation at supplemental cost

Arrival Date

Flight No. & Arrival Time

Departure Date

Flight No. & Departure Time

Payment Information

I am paying a deposit of US$ 150 per person to Discovery Indochina

No. of participant

by: bank transfer Credit card (Visa or Master only) Card Holder

No. of card

CVV-code

Expiry date

Amount person

I authorize Discovery Indochina to debit the total amount of:

from my credit card for the service of

Insurance & liability

All tour participants are required to have health and/or travel insurance to participate on the trip.

Name of insurance policy

Insurance No.

Expiration

Additional message

Others

Accommodations