Balesin Island Club Reservation Form
One reservation form per villa
Email address *
Membership Account No.: *
Your answer
Full Name: *
Your answer
Member's email address: *
Your answer
Membership Type: *
Landline Number: *
Your answer
Mobile Number: *
Your answer
Date of Arrival: *
MM
/
DD
/
YYYY
Flight Preference: *
Date of Departure: *
MM
/
DD
/
YYYY
Flight Preference: *
Village Preferences: *
Balesin
Bali
Costa del Sol
Mykonos
Phuket
St. Tropez
Toscana
1st
2nd
3rd
Additional Notes / Others:
Your answer
Occupants: *
Last Name / First Name / MI / Age / Relation / Birthdate / Contact Number / Weight in Kg
Your answer
Airfare: *
Please fill out for Airfare Special Billing Arrangements.
Your answer
Villa Accommodation: *
Please fill out for Villa Accommodation Special Billing Arrangements.
Your answer
Other Charges: *
Additional Notes:
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
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This form was created inside of Alphaland Development Inc..