2D1N Batam View Beach Resort 2 Bedroom Villa Ferry Package

RESERVATION FORM

PERSONAL INFORMATION
IMPORTANT!! Pls make sure that it is the name shown on your passport. (*) is a compulsory field
Title Family Name Given Name
IMPORTANT!! Pls furnish complete e-mail address so that our reply could reach you
E-mail Address * ( Correspondence E-mail address)
E-mail Address ( Second E-mail address,if any )
Telephone No
Fax No
Company Name (If applicable)
Correspondence Address
Country of Residing
Nationality *
RESERVATION DETAILS
Choice of Room
Types of Rooms Required
Number of Villa Required
Child No Bed
Child With Bed
Number of Adults
Number of Children
Preferred Departure Time (SIN - NFT)
Preferred Arrival Time (NFT - SIN)
Date of Check In (DD/MM/YY)
Date of Check Out (DD/MM/YY)
Special Request
Title Family Name/
Surname name
Given Name Nationality Date of Birth Passport No Passport Expiry Date
Credit Card Details
* Please provide full credit card details in order to have priority in booking process and cardholder must be one of the travelling party
Credit Card Holder Name *
Credit Card Type *
Credit Card Number *
Security Code * The last 3-digit number on the back of your Visa Card/Master Card, or the last 4-digit number on the front of Amex Card
Credit Card Expiry Date (month/year, example 12/15) *
Credit Card Issuing Bank *
Credit Card Issuing Country *
OTHERS
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Staff Name
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