Matahari Terbit Bali - Deluxe Bungalow and Restaurant

Reservation
Email Address :
* I would like to :
* Room Type :
Require Airport transfer?:	Yes No
* Number room(s) :
* Arrival date :	*(mm/dd/yy)*
Flight Details :
* Departure date :	(mm/dd/yy)
* Number of Pax(s) :

Details of Identity
* Name :
Date of Birth :	*(mm/dd/yy)*
Nationality :
Passport No. :
* Address :
* City :
* State :
* Zip Code :
* Country :
Office Phone :	Fax :
* Home Phone :	Fax :
Mobile Phone :
Special Request :

*Note; () Required Important : Reservation will be proceed only if either one of these forms has been filled in completely. Payment Confirmation (By internet/email) For the need of Payment Confirmation, you have to send your credit card details to us. You may transfer your credit card details either by internet or facsimile. Credit Card Accepted**

Matahari Terbit Bali
Deluxe Bungalows, Restaurant and SPA
Jl. Pratama - Tanjung Benoa
Nusa Dua 80363 Bali - Indonesia
Phone 62 361 771019 - Fax 62 361 772027
E-mail sales@matahariterbitbali.com