beachside-bali.com Phone +62-361-29-0122 Email villa@beachside-bali.com Reservation Villa Beachside Welcome to Villa Beachside Reservation form. If you have reservation, please complete and submit the form below. We will reply, after check the vacancy. Email Address Email Address Re-enter *Please check again Name Salutation *Please indicate Mr. Mrs. or Ms. Sex Sex male female Age 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 Age 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 Passport No Address 1 Address 2 City State or Province Country Postal Code Phone Number Example XXX-XXX-XXXX Arrival and depature of your flight infomations at the Denpasar Airport *If you need free airport transportation on arrival and departure, please complete the form below. Free airport transportation : Need free airport transportation Do not need free airport transportation Air line and Flight No on arrival : Example Garuda Indonesia GA715 Arrival day of Flight : Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month January February March April May June July August September October November December Year 2015 2016 Arrival time of Flight : Time 0: 1: 2: 3: 4: 5: 6: 7: 8: 9: 10: 11: 12: 13: 14: 15: 16: 17: 18: 19: 20: 21: 22: 23: Minute 00 05 10 15 20 25 30 35 40 45 50 55 Air line and Flight No on Departure : Example Garuda Indonesia GA714 Departure day of Flight : Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month January February March April May June July August September October November December Year 2015 2016 Departure time of Flight : Time 0: 1: 2: 3: 4: 5: 6: 7: 8: 9: 10: 11: 12: 13: 14: 15: 16: 17: 18: 19: 20: 21: 22: 23: Minute 00 05 10 15 20 25 30 35 40 45 50 55 Accommodation date and use number of rooms ■Check-in date : Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month January February March April May June July August September October November December Year 2015 2016 *Required ■Check-out date : Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Month January February March April May June July August September October November December Year 2015 2016 *Required ■Number of nigfts : Example 3 nights ■Number of persons : Select number of persons (Required) 1 person 2 persons 3 persons 4 persons 5 persons 6 persons ■Number of rooms : Select number of rooms (Required) Use 1 room only Use 2 Rooms Use 3 rooms Use 4 rooms ■Type of room : Select type of room (Required) R1 - Use Luxury Suite Ocean View (Two King Size Beds 2F) R2 - Use Deluxe Twin Ocean View (Two Semi Double Size Beds 2F) R3 - Use Deluxe Ocean View (King Size Bed 2F) R4 - Use Deluxe Garden View (King Size Bed 1F) *One room maximum two persons ■Use "Luxury Suite Private Plan" : Do not use Add optional - For each one night US$125 *Under the "Luxury Suite Private Plan" you can reserve the Luxury Suite for you and your loved one and then we can block the remaining three guest rooms for an additional cost. "Luxury Suite Private Plan" is also included Villa's exclusive car. If you use two or more rooms, please select roooms. ■Select rooom 2 : Select room 2 R2 - Use Deluxe Twin Ocean View (Two Semi Double Size Beds 2F) R3 - Use Deluxe Ocean View (King Size Bed 2F) R4 - Use Deluxe Garden View (King Size Bed 1F) None *If you use two rooms, please select rooom. ■Select rooom 3 : Select room 3 R3 - Use Deluxe Ocean View (King Size Bed 2F) R4 - Use Deluxe Garden View (King Size Bed 1F) None *If you use three rooms, please select rooom. ■Select rooom 4 : Select room 4 R4 - Use Deluxe Garden View (King Size Bed 1F) None *If you use four rooms, please select rooom. ■Early check-in Service : Do not use (Check-in after 14:00) Add optional (Between 8:00am and 14:00 incurs US$30) ■Late check-out service : Do not use (Check-out before 13:00) Add optional (Between 13:00 and 17:00 incurs US$30) Add optional (Between 17:00 and 20:00 incurs US$50) Comments villa@beachside-bali.com beachside-bali.com Copyright (C) 2013 Viila Beachside All Rights Reserved