ETN Hotel Reservation Form for
SEGARA VILLAGE HOTEL, DENPASAR,Bali

This Reservation Form is sent DIRECTLY to SEGARA VILLAGE HOTEL by E-Mail.
(NOT to the ETN Head Office, NOT to a travel agent or any other office)
SEGARA VILLAGE HOTEL will answer your request as soon as possible.
If your reservation is confirmed, SEGARA VILLAGE HOTEL will send you a Confirmation Number, the applicable GROSS or RACK Rate and the Discount Given.

Your details:

Family Name:
Initials:
Company Name: Optional !
Position: Optional !
Profession: Optional !
Street / P.O.Box:
City + State:
Country:
Postal / Zip Code:
Telephone Number: incl.Country + Area Code
Fax Number: incl.Country + Area Code
E-Mail: Absolutely necessary !
ETN Card Number:
ETN Card Expiry Date:

YES, I want to reserve the following Accommodation:


INDONESIA 80030    DENPASAR,Bali      P.O.BOX 3091, Jl.SEGARA AYU, SANUR
SEGARA VILLAGE HOTEL    Tel.(62)361-28 7242/8407  Fax (62)361-287 242
E-Mail: segara1@denpasar.wasantara.net.id
25% DISCOUNT on US$ 110-210                           TOURIST * 144 Rooms
The hotel is known and ideal for honeymooners and family.
Right on the beach,Balinese atmosphere with international facilities.
25% on Food Only (1NOV-23DEC Only) Open: 6-23 h.* FIRST CLASS * 150 Seats
European, Chinese and Indonesian cuisine.
A beautiful hotel, amongst lush gardens, built in Balinese style.
This property has the following Hotel (1-42) & Room (43-58) Facilities:
1-2-3-5-7-9-10-13-14-15-16-21-22-23-25-26-27-29-30-31-32-33-34-37-38-39
40-41-43-44-45-49-51-53-54-56-57-58

Arrival Information:

Arrival Date
Arrival Time
Arriving from
Arriving by
Arriving by Flight Number: (Optional !)

Departure Information:

Departure Date
Departing to
Departing by
Departing by Flight Number: (Optional !)

Accommodation requested (1 ETN Card needed for EACH Room)

x Single Room (1 person)
x Double Room (2 persons)
x Triple Room (3 persons)
x Quad Room (4 persons)

Car Rental requested (1 ETN Card needed for EACH Car)

Car Group
Car Pick-Up at

Remarks, Comments and Questions

Use the space below to place special requests, provide additional information, or ask any questions. You'll be answered promptly.


Credit Card Information

If your estimated Arrival Time is after 16.00 hours (4 pm), your reservation can only be guaranteed upon receipt by the Hotel of a ONE NIGHT deposit before your arrival OR by completing your Credit Card Information below.

SEGARA VILLAGE HOTEL realizes that you may not be very comfortable in sending your credit card info via Internet. That's why they advise you to send your card number in one of the following TWO ways:
  1. Send EACH block of 4 digits in REVERSE order !!
    EXAMPLE: Your credit card number is: 1234 5678 9123 4567
    Below you give your credit card number as: 4321 8765 3219 7654
  2. Send your credit card number by fax to: + (62)361-287 242

Inform how you send your credit card number:


Credit Card NUMBER 4 x 4 digits !
Expiration Date mm/yy
Name Card holder
Credit Card type