Bintan Agro Spa Resort

Reservation Form

PERSONAL INFORMATION
Important !! Resubmit if more than 3 guests is travelling . (*) is a compulsory field.
1ST Guest Name as per passport
Title Name
Guest Name as per passport
Passport Number
Expiry Date
Nationality *
Date of Birth
2ND Guest Name as per passport
Title Name
Guest Name as per passport
Passport Number
Expiry Date
Nationality
Date of Birth
3RD Guest Name as per passport
Title Name
Guest Name as per passport
Passport Number
Expiry Date
Nationality
Date of Birth
Important !! Pls furnish complete email address so that our reply could reach you
Email Address *
Telephone No
Fax No
Company Name (if applicable)
Correspondence Address
RESERVATION DETAILS
Pls select Package
Number of Ferry Tickets for Adult
Number of Ferry Tickets for Child
Require extra bed for Child Yes No
Depart from Tanah Merah Terminal
(Singapore Time) 		Monday - Friday
Sat, Sun, Eve & Public Holidays
Depart from Tanjung Pinang Terminal
(Indonesia Time)

Monday - Fri
Sat, Sun, Eve & Public Holidays
Date of check in
Date of check out
PAYMENT METHOD
Preferred payment method
Indicate here for any special request
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from where you get to know our site

If you encounter any return email OR difficulties sending your booking details through this form, you may send your booking details to our help desk at our main reservation office at email address help@asiatravel.com

A copy of credit card payment form will be emailed to you and please return the form duly completed and faxed to the following no. (65) 6887 5489

At your services always !

Bintan Agro Spa Resort