Tenggol Island

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RESERVATION FORM

Title	: Mr. Mrs. Ms.	Passport No	:
First Name	:	Nationality	:
Last Name	:	Occupation	:
E-mail Address	:	Diver	: Yes No
Contact Phone	:
Contact Fax	:

Arrival Date	:
Arrival Time	: :
Departure Date	:
Departure Time	: :
By Flight (Flight No: ) By Road
Airport Pick-up required ? Yes No

Preferred Room Type	:
No. of Rooms	:
No. of Adults	:
No. of Childrens	:

CREDIT CARD AUTHORISATION FORM (VISA/MASTERCARD/JCBCARD)

Name ( As per Credit Card )	:
Credit Card Number	:
Credit Card Type	:
Expiring Date	:
Signature ( As per Credit Card )	: After you print out this form

NOTE : Please click 'Print Preview' and print this form and fax together with photocopy of back and front of your Credit Card.

Our fax no is : +609-845 7302

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