Booking - Bali Desa Boutique Villa

For further inquiry & reservation, please fill-in the form below:

Personal Information

I would like to:
*First Name:
*Last Name:
*E-mail:
*Address:
City:
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Zip Code:
Country:
Phone:
Fax:
No of adult:
No of child :	Child age
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Reservation Detail

Check-in Date:
Flight No:	Time:
Check-out Date:
Flight No:	Time:

Package Type:
Number of room(s):
Extra bed required:	Yes No
Comments:

Payment Method

For Credit Card Payment, your reservation request can only be processed once we receive your credit card details. You may either include these details on this form or, if you prefer to send them by fax, you should submit this Internet / email reservation form first (without your credit details) and then fax to +62 (361) 772 678 the credit card details using this form within 24 hours. Please only use the fax form provided by printing the credit card section of this form.
Travel Cheque Credit Card Cash
Type of Credit Card:
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Exp Date:
Issuing Bank:

Bali desa a boutique villas with at home feeling PO BOX 182 Nusa Dua 80363 Bali Email : info@balidesa.com


Blok T, Kawasan Wisata Nusa Dua - Bali P.O. BOX 182 . Bali 80363 Indonesia Phn (62-361) 772688 Fax (62-361) 772678 info@balidesa.com www.balidesa.com