Please send the following information for your trip to   :  This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Your Full Name                    :
Mailing Address                  :
Country                                  :
E-Mail Address                    :
Home Phone                         :
Business Phone                   :
Cell Phone                             :
Passport Number                 :
Passport Expiration            : 
Passport Place of Issue     :

Packages selected               :               Surfing                   Boat Aileoita II     Date of booked     :

                                                                                                Boat Kaimana      Date of booked     :

                                                                                                Boat Melaleuca   Date of booked     :

                                                                                                Boat Oasis            Date of booked     :

                                                                Trekking                 Date of booked     :

Diving                    Date of booked     :

Type of booked                     : Single booked – Group booked ( please choose one )

Note : Please read our terms and conditions for more details…..

For more information please contact :

Mentawai Syndicate

office      : jl. Veteran no 47 A – B, Padang 25116 West Sumatera -  Indonesia

Phone     : +62 751 7871721

Email      : This e-mail address is being protected from spambots. You need JavaScript enabled to view it