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Reservation form
To book a tour with Blue and White Travel Center Co.,LTD, please fill the following reservation form. We will confirm your inquiry within one working day and will then send you by E-mail the detailed booking conditions as well as the total amount for your reservation.
Required items indicated with *.
Client Information
Title :	Mr. Ms. Mrs.
First name :	*
Last name:	*
Nationality:	Albania Algeria American Samoa Andorra Angola Anguilla Antigua Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Canary Islands Cape Verde Cayman Islands Chad Chile China Colombia Comoros Congo Congo, The Dem. Rep. Of Cook Islands Costa Rica Cote Divoire Croatia (Hrvatska) Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Islas Malvinas) Faroe Islands Fiji Islands Finland France French Guiana Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea (British) Guinea Republic Guinea-Bissau Haiti Honduras Republic Hong Kong Hungary Iceland India Indonesia Iran Ireland Israel Italy Ivory Coast Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, North Korea, South Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mexico Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Nevis New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norway Oman Pakistan Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saipan Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka St. Bathelemy St. Eustatius St. Kitts St. Lucia St. Maarten St. Vincent Sudan Suriname Swaziland Sweden Switzerland Syria Tahiti Taiwan, R.O.C. Tajikistan Tanzania Thailand Togo Tonga Trinidad And Tobago Tunisia Turkey Turkmenistan Turks And Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States of America Uruguay Uzbekistan Venezuela Vietnam Virgin Islands (British) Virgin Islands (US) Western Samoa Yemen Yugoslavia Zambia Zimbabwe *
E-mail :	*
Informtion for round trips
Round trip:	4 DAYS PHNOM PENH AND SIEM REAP ANGKOR
Number of visitors:	Adults: 0 1 2 3 4 5 6 7 8 9 10 Children under 12 in this room? 0 1 2 3 4 5 6 7 8 9 10
Additional bed:	Yes No	Extra Beds Required : 0 1 2 3 4 5 6 7 8 9 10
Baby Cot:	Yes No
Smoking room:	Yes No
Day of arrival:	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December
Remark: