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Berth Request Form
Contact Information
Name *
 
Passport / NRIC No. *
 
Nationality *
 
Home Address *
 
Postal Code / Zip code *
 
Email *
 
Country  *
Tel. No. *
(H)  
(O)  
(Mobile)  
Craft Information
Name of Craft *
 
Craft Licence No *
 
Port of Registry *
 
Type of Craft *
 
Boat Make & Model
Specifications *
LOA
Beam
Draft
Engine Mounting
Inboard
Outboard
Shaft Driven
Jet
Vessel Used For
Presently Berthed At
Gross Tonnage *
 
Engine Power (kw)
 
Engine Make & Model
Type of Fuel *
 
Booking Information
Expected Arrival Date *
 
Expected Time Of Arrival *
Request For *
Water
Electricity Power
Length of Stay *
Arrival Date:   Departure Date:  
Other Information
(if any)
* Field required
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