Please fill out the following information and we will contact you shortly to verify receipt of your information and answer any further questions you may have. Upon confirming your participation in the tour, a non-refundable deposit of $1,500 is required. Payment can be made by major credit card, check or wire transfer. We look forward to experiencing Bali with you. |
Choose Your Tour |
Land Cost Only, additional airfare required |
|
Dates and prices to be announced |
Borobudur Tour |
|
|
Tour of Borobudur and surrounding temples |
Concierge Level |
Land Cost Only, additional airfare required |
|
Bali – A Concierge Level Tour – an exclusive travel opportunity |
Custom Garden Experience |
|
|
Individualized tour dates and itinerary. We will contact you in regards to pricing. |
|
|
|
* Based on double occupancy. Options available for the single traveler, please contact us for details. Prices also are based on U.S. Dollar / Indonesian Rupiah currency exchange rates as of February 1st, 2007. Should exchange rates fluctuate significantly prior to departure, additional fees may apply |
|
|
|
All meals included except two dinners to enjoy on your own and lunch on day of arrival and departure. Alcohol, other then beer, not included except at cocktail receptions and other invited events. |
|
|
|
Major City - Gateway Cityi |
|
No Flight Required |
|
Economy Class |
|
Executive Economy Class |
|
|
|
|
|
|
|
* Fares shown do not include tax and fuel surcharge of $293 which is subject to change prior to time of booking. Should the airline impose higher fuel surcharges, you will be notified prior to ticketing. Economy class fares pricing is guaranteed but must be ticketed prior to December 31. Fares listed for first, business and executive classes are subject to change and will be reconfirmed prior to actual ticketing. |
|
Any City - Gateway City |
|
City: |
|
State: |
|
|
Economy Class. Please provide me connecting flight information and pricing.
Business Class. Please provide me connecting flight information and pricing.
No flight required |
|
Example chart |
|
Midwest – including Chicago and Detroit
Southeast – including Miami and Tampa
Northeast – including Boston |
|
Personal Information |
|
1. Salutation: |
First Name: Last Name: |
|
|
Birthdate: |
Passport Number:
|
|
|
Address: |
|
|
|
City: |
State:
Zip: |
|
|
E-mail: |
|
|
|
Day Phone: |
Evening Phone:
Fax:
|
|
2. Salutation: |
First Name:
Last Name:
|
|
|
Birthdate: |
Passport Number:
|
|
|
Address: |
|
|
|
City: |
State:
Zip:
|
|
|
E-mail: |
|
|
|
Day Phone: |
Evening Phone:
Fax:
|
|
Accommodations |
|
|
|
|
Special Requests For Room: |
|
|
|
Please contact me to discuss Villa and other accommodation upgrades. |
|
* We will contact you to discuss fees for single supplement. |
|
Special Requests |
|
|
Special Diet:
Yes
No |
|
|
|
If Yes, Please Explain: |
|
|
|
If you are a vegetarian and/or have food restrictions/allergies please bring it/them to our attention. |
|
|
|
Do you have any problems climbing or walking stairs?
Yes
No |
|
|
|
Please Let Us Know If You Have Any Other Special Needs Or Requirements: |
|
|
|
Emergency Contact(s) |
|
|
Phone:
Name:
Relationship:
|
|
|
|
Phone:
Name:
Relationship:
|
|
|
|
|