Venue Bali Lodge Company / Private Private Company Name Telephone Fax Email Contact Person Do you need an Events Coordinator? Yes No Number of Adults (Full day conference ) Number of Adults (Half day conference ) Arrival Date   Arrival Time Departure Date   Departure Time Accommodation Required Yes No Accommodation Info Number of Single Rooms People sharing a room How many nights Do you require a Honeymoon Suite Yes No Electronic Equipment that you will need us to supply: Will you need us to supply stationary? Yes No Stationary Info Stationary with printed company details: Yes No Special requirments