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Bali Discovery Tours
Komplek Pertokoan
Sanur Raya No. 27
Jl. By Pass Ngurah Rai,
Sanur, Bali, Indonesia

Tel:
+62 361 286 283

Bali Fax:
++62 361 286 284

U.S.A. Fax:(toll free)
1-800-506-8633

U.K. Fax:
++44-20-7000-1235

Australian Fax:
++61-2-94750419

24h:
+62 812 3819724

Charity Classical Concert - Saturday, December 3, 2005

Order Form

Please fill out the registration form below to reserve your ticket for the concert

Almost every field is required and only the additional comment is optional.

Seating is limited. Registration is only confirmed after full payment has been received by Bali Discovery Tours. You will be contacted once we receive your booking to arrange payment and delivery of tickets.

Our [Privacy Statement] explains how we handle the data that you are providing.

Charity Classical Concert
Date	Saturday, December 3, 2005 at 7:30 p.m.
Venue	Ballroom, Mercure Sanur Resort
Description	Price include pre-show cocktail.
Cost	Rp. 200,000 net per person

Lead Registrant's Details
Full Name
Email Address
Position
Company
Street Address
City
Phone Number
Fax Number

Accompanying Guests
	Name	Position
1.
2.
3.
4.
5.
6.

Additional Information (Optional)
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