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Agan Pension - Reservation Form NAME ADDRESS CITY COUNTRY --Select-- AfghanistanAlbaniaAlgeriaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBasutolandBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBophuthatswanaBorneoBosnia-HerzegovinaBotswanaBrazilBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCanary IslandsCape VerdeCayman IslandsCentral African RepublicChadChileColombiaComorosCongoCook IslandCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDahomeyDem. Rep. of CongoDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFed. States of MicronesiaFijiFinlandFranceFrench GuianaFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMexicoMoldovaMonacoMongoliaMonserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntilliesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeoples Republic of ChinaPeoples Republic of CongoPeruPhilippinesPolandPortugalQatarRepublic of ZaireRomaniaRussiaRwandaSamoaSan MarinoSanta LuciaSao Tome and PrincipeSaudi ArabiaSenegalSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSpainSri LankaSt. Kitts and NevisSt. LuciaSt. Vincent and the GrenaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwan R.O.C.TajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUSAUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SamoaYemenYugoslaviaZaireZambiaZimbabwe TELEPHONE EMAIL ARRIVAL DATE DEPARTURE DATE NUMBER OF PEOPLE Adult 7 - 12 0 - 6 DOUBLE BED --Select-- 1 2 3 4 5 SINGLE BED --Select-- 1 2 3 4 5 COMMENTS