Online Hotel Reservation Form - Exotic Bali Destination

Home - Reservation Form

Online Hotel Reservation Form
Please use this Reservation Form to make a reservation room.

NOTE: * fields are required.

FLIGHT DETAILS

Arrival Date
Flight No. Time

Departure Date
Flight No. Time

PERSONAL INFORMATION

Title
*

First Name
*

Last Name *

Company Name

E-mail Address *

Alternative e-mail

Address *

City *

Postal/Zip Code *

Country *

Phone Number *(country code - area code - phone number)

Fax Number (country code - area code - phone number)

HOTEL RESERVATION DETAILS

Check In Date
*

Check Out Date *

Lenght of Stay nights (s)*

Number of Persons Adult (s)* Children (Age 12 years old or uder)

Hotel Name
*

Room Type
*

Bed Type *

Breakfast Late Check Out

Transfer to Hotel Transfer to Airport

Additional Hotel Reservation
(Please write the same format as above if you wish to stay in different hotels during your visit)

ADDITIONAL INFORMATION

How do you know our website?
other resources

How many time have you visited Bali?

Special Request / Comment

C/o. Jalan Danau Tamblingan Raya 21
Taman Griya, Jimbaran, Bali - Indonesia
Phone : +62.361.773363 (Hunting)
Fax : 62.361.774015
E-mail : info@exoticbalitravel.com