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Spa Package

Spa Package: *

No. of Persons: *

Personal Information

Title: *

Firstname: *
Lastname: *
Telephone: Please include country & area codes
Fax: Please include country & area codes

Email Address: *

Address:

State/Province:

Country:

Zip Code:
Date of Treatment:
Preferred Time of Treatment:

Flight Information

Arrival Flight No.:

Arrival Date:

Departure Flight No.:

Departure Date:

Please indicate if airport
pick up Service is required:

Yes No

Pick up time:

Hotel Pick Up
Please indicate if hotel
pick up Service is required:		 Yes No
Hotel Name:
Hotel pick up time:

Additional Requirements

Please Indicate Here:

The Nakalay Spa
6/2 M.6 Nakalay Bay, Patong Beach, Kathu Phuket 83150 Thailand
Tel: (66 76) 290 334-42 Fax: (66 76) 340 348
E-mail: info@nakalayspa.com