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Laguna Holiday Club Explorer Pass Application

Please tick the relevant boxes:

Which of these holiday destination have you visited before?

Phuket
(Thailand)
Bintan
 (Indonesia)
None

Have you ever stayed at _________ before?
Laguna Phuket
Yes
No
Angsana Resort & Spa Bintan
Yes
No

What holiday activities are you looking for?
Tennis
Beach/Relax
Fitness
Water sport
Squash
Diving
Horse riding
Spa/Beauty
Fishing
Culture
Entertainment
Golf
Sailing
Excursions
Shopping

In the past 3-4 years, where have you been on holiday?
Europe
America
Africa
Australia
Middle East
Asia

What languages do you speak?
English
Thai
Mandarin
Cantonese
Japanese
Other

Which Credit Card do you use when on holiday?
Visa
American Express
Diners
Mastercard

What package do you wish to purchase?
Phuket (Thailand)
Golf Getaway
Phuket FantaSea
Island Discovery
Spa Relaxation
Free and Easy Getaway
 
 
Chiang Mai (Thailand)
Chiang Mai Getaway
(1 Bedroom)
Chiang Mai Getaway
(2 Bedroom)
Chiang Mai Eco Tour
(1 Bedroom)
Chiang Mai Eco Tour
(2 Bedroom)
Hua Hin (Thailand)
Free and Easy Getaway
Putahracsa Resort
Pattaya (Thailand)
Free and Easy Getaway
Spa Relaxation
Bintan (Indonesia)
Golf Magic
Spa Sensation

Persons travelling
Name
Date of Birth
Husband or Wife's Name
Date of Birth
Address
City
Country
Postal Code
Tel. Home
Tel. Office
Mobile
Fax
E-mail

Children under 18 travelling with you (max. 2)
Name Age
Name Age

Marital Status
Married
Living together as a couple
Single
Divorced
Widow

What is your joint monthly income (US$)?
Below 1,500
1,500-2,000
2,000-2,500
2,500-3,000
Above 3,000
   

Months and dates you would like to travel?
(please give alternative dates)

Month Preferred Dates or
Month Preferred Dates or
Don't know yet

Was this offer recommended to you by a Laguna Holiday Club or RCI member?
Yes, I was recommeded by
Membership No:
No


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