For reservation please fill below:

Personal Information
   
I would like to:
make a booking
  request more information
*First Name:
*Last Name:
*E-mail:
Address:
City:
Country:
*Phone:
Fax:
 
Reservation Detail
   
*Type of Car:
Date of Service:
Time of Pick-Up:
Pick up Location (Hotel in Bali):
Please describe us in details if there is any specific request related to the above services:
*) required
 
 
Payment Method
For Credit Card Payment, your reservation request can only be processed once we receive your credit card details. You may either include these details on this form or, if you prefer to send them by fax, you should submit this Internet /email reservation form first (without your credit details) and then fax to +62 (361) 978 145 the credit card details using this form within 24 hours. Please only use the fax form provided by printing the credit card section of this form.
Travel Cheque Credit Card Cash
Type of Credit Card:
Card Holder's Name:
Credit Card Number:
Exp Date:
Issuing Bank:
   
Please read carefully The Terms & Conditions.
*
I agree with the Booking Terms & Conditions.
*
I do not agree with the Booking Terms & Conditions.
   
*) required
 
   
   
   
 

:: Bali Limousine Service :: Bali Car Rental :: Bali Wedding Car ::

BALI LIMOUSINE

Jalan Gatot Subroto Barat No. 101, Denpasar, Bali, Indonesia
Phone: (62 361) 7447877 ; Fax: (62 361) 410757
Email: info@balilimousine.com