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Mekong Delta Custom Trip

Please fill in the form below. You will receive confirmation of your request from Sales Department by e-mail within 24 hours.

Address: 216 De Tham Street, Dist 1, Ho Chi Minh city, Vietnam
Tel : (84-8) 39204766 - 39204767 - 39205847 (6 lines)
Fax: (84-8) 39205377
E-mail: vietnamtnktravel@hcm.vnn.vn

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CUSTOMER INFORMATION

Full Name (*):
Email(*):
Confirm Email(*):
Alternate email:
Phone Number(*):
FAX Number:
Mailing address:
Nationality(*):
City:
State / Province:
Zip / Postal code:

FLIGHT TICKET INFORMATION

Anticipated date of travel(*):
How many days you intend to go ?:
Number of people (*):
How many children are in your
party and what age are they ?
If you have kiss please fill here!
Port of arrival ?(*):
Port of exit ?(*):

Where would you like to visit ?

 Bac Lieu  Ben Tre  Cai Be
 Can Tho  Cao Lanh  Dong Thap
 Long Xuyen-Chau Doc  Ha Tien - Phu Quoc  My Tho
 Rach Gia  Soc Trang  Tra Vinh
 Vinh Long
Others - please specify!

What type of transportation would you prefer?

 Airplane  Car  Bicycle
 Motorbike  Hydrofoil  Bus
 Motorbike  Boat  Jeep ou 4WD
Others - please specify!

What level of accommodation would you prefer ?

 Budget (< 30 US$)  Standard (> 30 US$)  Superior (> 50 US$)
 First class (> 70US$)  Deluxe (> 100 US$)  Luxury (> 200 US$)
Others - please specify!

Would you like us to include any meals in your itinerary ?

 Breakfast  Lunch  Dinner
Others - please specify!

ADDITIONAL INFORMATION

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