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    Reservation Form of Baleka Beach Resort  
    Please fill in the request form below :
    (Fields marked with an asterisk * are required     )
    Personal Informations :
    Title :   Please select the title of the guest for this reservation.
    First Name :   Please enter the first name of the guest for this reservation.
    Surname : * Please enter the surname of the guest for this reservation.
    Number of Adult : *
    Number of Child :
    		Please enter the number of adults and children in this party
    Street Address : * Please enter the street address of the guest for this reservaton.
    City :   Please enter the City of the guest for this reservation.
    State/Province :   Please enter the State/Province of the guest for this reservation.
    Post Code :   Please enter the Post Code of the guest for this reservation.
    Country of Residence : * Please enter your Country of Residence for this reservation.
    Nationality : * Please select your Nationality for this reservation.
    Phone : *
    Country Code :
    		Area Code :
    		 Dialing Number :
    		Please enter your contact phone number as we may call you back for booking amendments (incl. country and area dialing code).
    Fax :   Please enter your Fax Number for this reservaton.
    (incl. country and area code).
    E-mail Address : * Please enter your E-mail Address for this reservation.
    Flight Detail :
    Arrival date : * Please enter the arival date of your flight for this reservation.
    Departure date : * Please enter the departure date of your flight for this reservation.
    By (Flight) :   Please enter your flight number for this reservation.
    Reservation Detail :
    Check in : * Please enter the Check in date for this reservation.
    Chec Out : * Please enter the Check out date for this reservation.
    Room Type : * Please select the room type you require.
    Room Category : * Please enter the room category you require.
    Extra Bed :   Please enter the number of extra bed you require.
    Meals :   Please enter the meals you require.
    Airport Transfer :   Yes Check if you require airport transfer.
    Ohter Services :   Please enter of any other services you require.
    Please describe your inquiries in details :
    * required field