RESERVATION FORM (Accommodation)
I would like to make
:
Inquiry
New Booking
My Information
*
Name
:
*
Tit
t
le
:
select tittle
Mr.
Mrs.
Ms.
Nationality
:
Passport Number
:
Address
:
Telephone number:
Fax number:
*
E-mail address
:
Accommodation
*
Arrival Date
:
Arriving Flight
:
Time
:
*
Departure Date
:
Departing Flight
:
Time:
*
Hotel’s Name
:
*
Type of Room
:
Number of Room
:
1
2
3
4
5
Bed Configuration
:
Single
Double
Twin
Extra Bed
:
0
1
2
3
4
5
No. of Person(s)
:
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
adult(s)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
children
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
infant(s)
Airport transfer
:
Yes
No
(for “Yes” option, additional charge may apply)
Special Request
:
Credit Card’s Details
Type of Credit Card
:
Number
:
Expired Date
:
Issuing Bank
:
Card Holder Name
:
3 (three) last digits
behind your credit card
:
Please be advised, your credit card details only to secure and guarantee your reservation. We will not be charging your credit card for the reservation you made, otherwise there is any cancellation or no show fee. You may settle the payment direct to the hotel by cash or credit card.
The copy of your credit card (both sides) and passport may require, please kindly send them along with your reservation details by e-mail.
Should you feel not comfortable sending your credit card or other details by e-mail, send them by fax is the alternate to +62 361 222469.