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INPORTANT : Your credit card will be used as a guarantee ONLY and will be charge if there is any cancellation within certain period of cancellation policy. All payment will be collected upon arrival in Bali except for reservation Beyond Bali.
Or You can send your one night deposit as guarantee through MoneyGram International money transfer service.
Attention to: Erning Hadi - Destination : Bali Indonesia
Information Credit Card Detail for Guarantee Reservation by bali-travelina.com

Accommodation :
Booking Reference :  
Hotel Name :  
Room Type :  
2nd Choice Hotel Name :  
No. of Room (s) :  
No. of Adult (s) :  
No. of Children (s) :  
Ages of children :  
Extra Bed Required :  
Check In :  
Check Out :  
Special Requests :  
Total Amount :  
Airport Transfer :  

I wish to confirm and guarantee my reservation by :

Credit Card Information :
Please be assured that we will not debit your credit card until you have agreed on the accommodation and until your reservation is confirmed.
*Type of Credit Card : VISA MASTER CARD MoneyGram
*Credit Card Number :
*Expiry Date (MM/YY) : / (As shown on card)
*3 Digits # on Back Cover of Card
(as shown on the signature panel on your card)
*Credit Card Holder Name :
First Name Middle Name Last Name
(As shown on card)
*Card Holder Address :
*City :
*State or Province :
*Postal Code :
*Country :

Phone :
*Email Address :



Note :
  1. Enclose with the form are :
    - A copy of the card owner's passport
    - A copy of both sides of the credit cards
  2. The total amount has been added 3% bank charge from the total cost.
  3. Payment by credit card is normally charged in local currency, our company takes no responbility for subsequent exhange retes applied by credit card vendor after the client't deparure, and when the statement is comverted in to the local currency

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Last Updated: March 2010