Title *

Ms. Mr.

First Name *		Last Name *

Area Code *		Tel *

Email Address for Order Confirmation *

Customer Pick-Up: please come to the Restaurant about 20 minutes after ordering.

Special Wishes

I agree that the data I supplied to Ban Thai Restaurant can be used for its information purposes.

* Mandatory Info. Must be supplied. Recording of Address Data Would you like your address data to be stored, so that it does not have to be manually reentered for future orders?

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Opening hours: Unfortunately no Pick-up or Delivery at the Present Time.