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Last Name* |
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Middle Name |
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First Name* |
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Date of Birth* (dd/mm/yyyy) |
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Age* |
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Place of Birth |
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Nationality* |
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Passport No.* |
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Place of Issue* |
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Issued Date* (dd/mm/yyyy) |
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Expired Date* (dd/mm/yyyy) |
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Contact address in Thailand* |
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Province* |
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Postal Code* |
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Email* |
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Home Phone |
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Mobile Phone*
(If none, please put a number 0) |
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Fax |
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Contact address in your home country* |
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Country* |
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Postal Code* |
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Home Phone |
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Mobile Phone*
(If none, please put a number 0) |
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Fax |
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Emergency Contact Person |
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Name* |
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Relationship* |
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Address* |
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Postal Code* |
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Email |
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Home Phone |
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Mobile Phone*
(If none, please put a number 0) |
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Fax |
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Others |
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Any existing member recommending you to TLM
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Please name your favorite media
(newspapers,magazines,websites,etc.) while staying in
Thailand |
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What are your hobbies / personal interests? |
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Want TLM to help you find your living places?
(If yes, what kind and in what area?) |
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** An existing member who recommends a new member will get TLM special goodwill gift by 2% discount deducting from the service fee of next year (The Diamond Package and Blue Diamond Package are not included in this campaign). |
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| This is very important to us. What kind of additional services could we help serve you more during your long stay periods? (No matter what it is ,please feel free to let us know.) |
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| I agree with the Terms &
Conditions issuing by TLM and certify that the
information provided in this application is
update and ture. |
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