Agriculture Reservation

Contact Person

Bambang H

Irmayani

Company Address:
Jl. Letda Kajeng, 21B, Yang Batu, Denpasar, Bali
Tel / Fax : +62 361 263862
sales@balimeruholidays.com
www.balimeruholidays.com

Licence:
No: 940/D2/BPW/VII/98

Credit Card Accepted

Make Reservation

Please feel the form below to me an Enquiry or Reservation

Personal Information

I would like to:
make a booking

request more information

*First Name:

*Last Name:

*E-mail:

City:

Country:

*) required

Reservation Detail

Arrival Date :

MM-DD-YY

Flight No:
Time:

Depature Date :
MM-DD-YY

Flight No:
Time:

Package Name:

Hotel Name:

Room Type:

Num of Room:
(total room required)

Num of Adult :
Child(s)

Extra bed:
Yes No

Comments:

Payment Details

Card Holder:

Card Number:

Card type:

Expire Date:
/ MM / YY

Security Code:
Enter 6 letters as shown below !

Secure Site: SSL by thawte
BmH21B

***IMPORTANT ***
Please Read Before Making Your Booking

BOOKING TERMS & CONDITIONS
I AGREE TO THE TERMS ABOVE
BY CHECKING THE BOX, YOU ACKNOWLEDGE THAT YOU HAVE READ OUR BOOKING TERMS AND CONDITIONS AND UNDERSTAND THEM.

YOUR RESERVATION WILL BE PROCEED ONLY IF THE FORM HAS BEEN FILLED COMPLETELY. PLEASE CHECK YOUR EMAIL ADDRESS OR WE CANNOT PROCESS YOUR RESERVATION IF IT IS INCORRECT

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