RESERVATION

To make a reservation, please fill the following form completely!
Thank you!


PERSONAL INFORMATION
* Full Name :
* Title :
* Address :
* City :
* State :
* Zip/Postal Code :
* Country :
Passport No :
* Phone/Fax No. :
* Email Address :
   
BOOKING DETAILS
Room Type
Quantity Room
* Check in Date / /
* Check Out Date / /
Flight No.
# Of Adult
# Of Children

Additional Comments:
   
Verification Code:
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  form with * is required to be filled
   

SPECIAL OFFER

CASA PADMA SUITES

Jl. Padma - Legian - Kuta - Bali - Indonesia
Tel. 62-361-753073.  Fax. 62-361-755925
Email. sales@casapadmasuites.com