Name:
Phone No:
Fax:
Email:
Arrival Date:	Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Date Year 2007 2008 2009 2010
Flight Details:
No. of Persons:	Adult 0 1 2 3 4 5 6 7 8 9 10+
	Children 0 1 2
	Age of child no 1 Age of child no 2
Departure Date:	Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Date Year 2007 2008 2009 2010
Apartment style / size:	One Bedroom Two Bedroom Three Bedroom Penthouse
Comments:
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Beach Melati Apartments and Coffee Shop

Jl. Padma Utara No 10, Legian. Bali. Indonesia



phone: 62 361 751526, 763904

fax: 62 361 751526, 763904