Paya Beach Resort

Full Name :

(required)

Sex :

Male Female

Correspondence Address :

Contact Numbers :

Home
Office
Hp/Pager
Fax

Email Address :

(required)

Number of :

Adult :
Child (below 12yrs) :
Infant (2yrs) :

Check-In Date :

- -

Check-Out Date :

- -

Room Type :


Single :		Double :
Triple :		Quad :

Mode of Arrival :

Method of Payment :

(required)

Credit Card Number :

(required except Bank TT)
kindly present same credit card upon check-in day at Resort

Expiry Date :

(required except Bank TT)

Special Request / Notes :

Once your reservation request is confirmed, the full non-refundable payment is required by banking into our bank account or deduction made through your credit card. Our bank details are as follows:

Account Name:	Paya Beach Resort Sdn. Bhd.
Name of Bank:	AmBank (M) Berhad
A/C No:	068 201 200011 1 (Mersing Branch)
Swift Code:	ARBKMYKL
Company Registration No:	416417-A

Passenger Manifest :
(*based on departure date)

No.	Full Name	Age	Sex	Nationality	Date of Birth	Country of Birth	Passport No.	Date of Expiry

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