Bali Hotels Villas Accommodation Reservation Form

Hotel RESERVATION FORM

First Name

Last Name

Title

E-mail Address

Please fill the correct e-mail address

Telephone. no

(Country code + area code + telp.no)

Fax. no

(Country code + area code + Fax.no)

Nationality

Other Participants

Full Name	Date of Birth

For more participants, please type below:

Your Flight to Bali

Arrival (Flight no )		Arrival Time
Departure (Flight no)		Departure Time

HOTEL RECORD
Hotel Name
Package Name	if you book a packages
Check in date		Check out date
Room Type
Type of Bed		Total of Room
Special Request	Extra Bed Request YES NO Airport Transfer Request YES NO

Method of Payment Bali Star Island Tour has a privilege to receive some method of payment to secure the booking, therefore please kindly fill/select one of the payment method listed below:
Method of Payment	Credit Card Bank Transfer/Cash Get Bank Transfer Help
Type of Credit Card
Credit Card number
Expire date	(Month, Year)
Name of card holder
Security code

Before submiting your reservation, please kindly find clearly the terms and conditions including the cancellation policy on the hotel rate to avoid misunderstanding occur.

Once you have submitted your reservation, it will be replied by Bali Star Island Tour within 24 hours and please ensure you write the correct e-mail address at the space above to process your booking otherwise it can not be proceed. If you have not receive any answer after 24 hours, please contact our reservation at info@balistarisland.com.

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