Bali: Villa Inquiry Form

Villa Inquiry Form

As a first step to an unforgettable vacation in Bali, please complete and return
this form so we can recommend those villas which suit your requirements best.
Villas in Bali are often reserved many months in advance. Therefore, please
send us your inquiry as early as you can.

DETAILS OF YOUR PLANNED VISIT TO BALI:

Number of people travelling together:
	Adults, Age(s)
	Children, Age(s)

Number of bedrooms required
Arrival Date
Departure Date

Please note that some villas require a minimum stay of one week.

Please rate the importance of the following facilities and/or services on a scale from 1 (Very Important) to 5 (Not Important):

Very Important	1	2	3	4	5	Not Important
Air-conditioned bedrooms:
Private swimming pool:
Beach front location:
Direct Telephone/Fax:
Intern'l TV programs:
Cook for Western food:

Other Requirements

i.e. special foods/diets, baby-sitter, nurse, special guide, interpreter, sports coach, etc.

Main interests and planned activities during my/our stay in Bali:
	Relaxing in our villa.
	Getting to know Bali and its people, customs and culture.
	Going on adventure trips.
	Exploring Bali's night life.
Sports (please specify):
Other interests (please specify):

Our budget PER VILLA PER DAY is (please tick the boxes showing the price ranges you are interested in):

US$300 to US$500		US$500 to US$750
US$750 to US$1,200		US$1,200 and above

Important: if your budget is below US$280 per day for a one-bedroom suite or below US$150 PER BEDROOM PER DAY for larger villas, please do NOT use this form but visit the BALI HOTEL BARGAIN FINDER site.

PERSONAL DETAILS:

Salutation:	Other:
Family Name:
Given Name(s):
Business Title:
Nationality:
E-mail Address:

Please fill in ALL address fields below that we can contact you either by e-mail, fax, telephone or even snail mail. Communications are not always reliable, and it's good to have all options.

Company & Address:

Company Phone:
Company Fax:

Home Address:

Home Phone:
Home Fax:

GENERAL INFORMATION

I have rented a vacation villa before: Yes No

If Yes, when & where?

I have visited Bali before: Yes No

If Yes, where did you stay?

I am interested in buying a vacation/retirement home in Bali. Yes No

Please let us know how you found our web site.
Link from (please name site)
Web Search (please name search engine)
Other (please specify)

I do not wish to receive any e-mail with information on Bali or any special offers not directly related to this specific inquiry.

Thank you for completing this long form. The information provided will help us to find and recommend those villas suited best for your personal requirements.




Balivillas.com/Bali.com Ltd D&B D-U-N-S No. 66-389-8141 Reservation & Service Center Tel. +62-361 703-060 (12 lines) Fax +62-361 701-577 E-mail: info@balivillas.com