Langkawi Online Secure Booking Form
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For security purposes, please fax the form to (6)04-969 8889 |
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Please Fill The Form Below Carefully |
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To Print This Form Please Fill It Up and Press [Ctrl] Key + P |
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FIELDS MARKED WITH * ARE REQUIRED! |
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LANGKAWI CORAL RESERVATION |
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Snorkeling Package: RM 198.00 / Adult RM 158.00 / Child ( 3 yr - 12 yr ) |
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Diving Package : 2 Dives with equipment. RM 300.00 / Adult |
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Introductory Dive with Dive Master Escort. RM 350.00 / Adult ( RM 120.00 must directly pay to counter upon departure ) |
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Please provide all the names for the ticket, and with full detail. |
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Passenger Name |
Ticket Type |
Gender |
Nationality |
Passport/ I/C No. |
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| 2 |
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| 3 |
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The ticket rate is inclusive of Government Environmental Conservation Charge of RM 5.00 |
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Departure Date:* |
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Please provide the Hotel or Resort information if you would like the free pickup to Jetty Kuah. For those who wish to go to Jetty Kuah by themselves will need to be there at 8.00 am. |
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Hotel or Resort : |
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Your Name:* |
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E-Mail Address:* |
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Phone: |
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Fax: |
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| Type Of Credit Card :*
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MASTER VISA |
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Card No:* |
CVV No. |
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Card Holder Name:* |
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Expiry Date:* |
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Card Billing Addr:* |
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Please Read The Refund Policy & Cancellation Period In The Terms & Condition Page Before You Submit Your Credit Card Information! |
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Additional Message: |
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