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Atlantis Puerto Galera Resort Sabang Beach, Puerto Galera Oriental Mindoro 5203 Philippines

Atlantis Dumaguete Resort Liapayo, Dauin Negros Oriental 6217 Philippines

www.atlantishotel.com

TelFax: +63 (0)43 2873066 to 67

Fax

:

+63 (0)43

2873068

CellTxt: +63 (0)917 5620294

TelFax: +63.(0)35.4240578 Tel: +63.(0)35 4252327 CellTxt: +63.(0)918 9357491

Tel

Fax

Email

@

Nationality

Company Name

Passport #

Place/Date Issued

If you or any of your party will have a special event (birthday, anniversary, 100th dive, etc) during your stay, please tell us about it?

Jan

Feb

Mar

Apr

1

2

3

4

5

6

7

May

Jun

Jul

Aug

8

9

10

11

12

13

14

Sep

Oct

Nov

Dec

15

16

17

18

19

20

21

Please answer the questions

Are you a certified diver? If non-diver, are you interested learning to dive?

Can we inform you about our excursions? Would you like details of our FREE Atlantis Club Membership?

Yes

No

Please fill out this form with printed letters as required by the Department of Tourism.

City Zip

I visited Atlantis Puerto Galera before

I visited Atlantis Dumaguete before

Address

Street

Country

22

23

29

30

Year

24

31

25

26

27

28

First Name Names of children in room

Your Birth Date

Last Name

Arrive as a Guest… Leave as a Friend…

Check-In-Date.

Room No.

Check_Out-Date

Room Rate

FOR OFFICE USE

Payment Method

CC

Cash

TC

Club Membership

Silver Emerald

Platinum Diamond

Gold

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