Club Landmark Application Form
Name:
Mr.
Mrs.
Ms.
Dr.
*
Last Name:
*
Birth Date:
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
Month:
January
February
March
April
May
June
July
August
September
October
November
December
*
Company Name:
*
Address:
*
Phone:
Country
-
Area
-
Number
-
-
*
Fax:
Country
-
Area
-
Number
-
-
Home Address:
*
Phone:
Country
-
Area
-
Number
-
-
*
Fax:
Country
-
Area
-
Number
-
-
E-mail Address:
*
I would like to:
Apply for Club Landmark Membership at only baht 4,900.- per year
Payment:
Cash
Cash payments should should be made at the Front Desk in The Landmark Bangkok hotel.
Bank Transfer
- Bangkok Bank
(Bangkapi Sub Branch)
Siam property Development Co.,Ltd.
Saving A/C No. 105-05-26530
- Thai Military Bank (Landmark Plaza Sub Branch)
The Landmark Bankok
Saving A/C No. 112-2-00001-9
Cheque Bank
Branch
Cheque Date
Number
Please make your cheque payable and crossed to "Siam Property Development Co.,Ltd. or The Landmark Bangkok"
Credit Card
Visa
Amex
Diners
Master card
Number
Expiry Date
Card Collection at
The Landmark Bangkok Hotel
Company
Home
Mailing
Mailing Address
