[select one] Bohol Malapascua

Title:

Mr.  Ms./Mrs.

First Name:

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E-mail Address:

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Phone:
+Ctry.Code (AreaCode) xxx-xxxx

Residence Address:

House/Building No.                  Street

City 

Country:  United States of America Canada Afghanistan Albania Algeria Argentina Australia Austria Belgium Brazil Bulgaria Chile China Colombia Costa Rica Croatia Czech Republic Denmark Ecuador Egypt El Salvador Finland France Germany Greece Hong Kong Hungary India Indonesia Ireland Israel Italy Japan Jordan Korea, South Lebanon Malaysia Mexico Morocco Netherlands New Zealand Norway Pakistan Peru Philippines Poland Portugal Puerto Rico Romania Russia Saudi Arabia Singapore South Africa Spain Sweden Switzerland Taiwan Thailand Turkey U.S. Minor Outlying Islands Ukraine United Arab Emirates United Kingdom Venezuela Yugoslavia (Former) [Select a country]

Arrival Date:

[select month] January February March April May June July August September October November December , (Month Day, Year)

Arrival Time:

  Flight No. 

Departure Date:

[select month] January February March April May June July August September October November December , (Month Day, Year)

Departure Time:

  Flight No. 

Guest Number:

Adults     [Select Choice] 1 - one 2 - two 3 - three 4 - four 5 and more   Children  [Select Choice] 0 - none 1 - one 2 - two 3 - three or more

Preferred Accommodation:

Bohol: [Select an Accomodation] The Chalet Villa Suite Executive Room Deluxe Room Superior Room Economy Room

Transfer:

Cebu Airport to Resort  None   Roundtrip (Cebu-Resort & Back)

Title Mr. Ms. Age

Title Mr. Ms. Age

Title Mr. Ms. Age

Diving Interest:

[select one] No Diving Check-up/Refresh Dive Scuba review program 2 boat dives 4 boat dives 6 boat dives 8 boat dives 10 boat dives 1 night dive 2 night dives 4 night dives 2-day Apo Island safari 3-day safari 4-day safari 5-day safari 6-day safari 7-day safari

with own diving equipment  none

Diving Course Interest:

[select one] No Course Discover Scuba Diving PADI Open Water PADI Advanced Open Water PADI Emergency First Response PADI Rescue Diver PADI Dive Master PADI Assistant Instructor

Mode of Payment:

[Select Type of Payment] Cash - US$ Cash - Pesos Credit Card - Visa Credit Card - Mastercard Travellers Cheques

Special Requests and other requirements:

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