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
Mr.
Mrs.
Miss
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
2 Bedroom Villa
Types of Rooms Required
Please Select
Single
Twin/Double
Triple
Number of Villa Required
1
2
Child No Bed
NA
1
2
Child With Bed
NA
1
2
Number of Adults
1
2
3
4
5
6
Number of Children
Nil
1
2
3
4
Preferred Departure Time (SIN - NFT)
Please Select
0800
1000*
1100*
1200
1420
1620
1830
2030
Preferred Arrival Time (NFT - SIN)
Timing to be booked & reconfirmed on arrival
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
Mr.
Mrs.
Ms.
Miss.
Mstr.
Mr.
Mrs.
Ms.
Miss.
Mstr.
Mr.
Mrs.
Ms.
Miss.
Mstr.
Mr.
Mrs.
Ms.
Miss.
Mstr.
Mr.
Mrs.
Ms.
Miss.
Mstr.
Mr.
Mrs.
Ms.
Miss.
Mstr.
Mr.
Mrs.
Ms.
Miss.
Mstr.
Mr.
Mrs.
Ms.
Miss.
Mstr.
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
Visa Card
Master Card
AMEX
*
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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