Essential information

Thank you for taking the time to complete this form. It will take a couple of minutes to fill in but it will enhance your travel experience greatly as the info provided will help us tailor our services to serve you better.

All info is treated confidential and will be used exclusively by Wakatobi Dive Resort and your travel agent, should you have chosen to book through one.

No data will be sold or given out to third parties.

Your personal information
First name
Middle name
Last name
Preferred/given name
Gender
Salutation
Street address
City
State or province
Postal code / Zip
Country
Email address
Repeat email
Home tel
Work tel
Cell/Mobile
Date of birth	(Please supply date in the format DD/MM/YYYY)
Nationality
Passport #
Passport Expiry Date	(Please supply date in the format DD/MM/YYYY) Please note: for entry into Indonesia, your passport MUST be valid for more than 6 months from your arrival date.

In case of emergency please contact
Name
Telephone	(Please include country /area code)
Dive skills and preferences
Nitrox requested?	Yes (Please bring proof of Nitrox certification)
Nitrox course desired?	More info
Diving since
No of dives
# days diving per year
Certification agency
Certification level	(If you are a non-diver please indicate that here)
DAN member number
Tank valve type required
Desired tank size
Preferred style of diving

Preferred style of snorkeling

Remarks on diving / snorkeling preferences

Private Dive / Snorkel Guide Desired? (Resort only)
(Minimum four days More info)
When would you like a private guide provided?
(This service depends upon availability)
Comments about private dive guide service
(Any preferences or requirements that you may have)

Travel preferences
Accommodation upgrade desired?	(If our availability allows, would you like to learn more about upgrading your Bungalow during your stay with us?)
Wakatobi Concierge Services
(Would you be interested in optional concierge service in Bali? More info)
How did you find us?
My travel agent
Arrival date	(The date when you will be arriving in the resort or boarding Pelagian)
Estimated luggage weight
(Please note, this information assists us to anticipate the remaining cargo space available to supply our kitchens with perishable goods. Further information regarding luggage allowance can be found here)
Dive Gear Rental	(If you need to rent, please specify items and size)
Photographer?
I'll bring camera
Dietary requirements	(For example do you prefer meat, fish or vegetarian food?)
Bed configuration preference	(How many beds will you and your room-mate need in your Villa Bungalow?)
Any other special requests for our Bali logistics office?
In case of flight changes, delays, itinerary changes

Info about your overnight in Bali before boarding the flight to Wakatobi
Date of arrival in Indonesia	(Please supply date in the format DD/MM/YYYY)
Arrival flight	Flight # Arrival (hh:mm) (Please ensure the flight details are correct so that we can greet you after you have passed through immigration.)
Hotel name
Travel agent or contact person
Departure date from Indonesia	(Please supply date in the format DD/MM/YYYY) For further details on Indonesia Visa Regulations visit our FAQ page.
Departure Flight	Flight # Departure (hh:mm)
Others
Any other special request for the resort?
Health Status?	Please be aware that there is only limited medical assistance in the resort, and no hospitals or doctors available in the area. We suggest you ask a doctor whether you are fit for travelling and diving.

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Essential information

Your personal information

In case of emergency please contact

Dive skills and preferences

Travel preferences

In case of flight changes, delays, itinerary changes

Others