CIQ Reservation Form 3 Please enable JavaScript in your browser to complete this form. Nirup Island - CIQ Reservation FormName of Yacht Owner *Contact Name (Captain/ Owner/ Agent/ Yacht Representative) *Phone Number *Email *Owner's Address *Membership Status * MemberNon-MemberMembership No. * Vessel ParticularsVessel Name *Vessel's Type *MotorSailingMonohullCatamaranTrihullFlag of Vessel *Units for Measurement *Feet (ft)Metre (m)Length *Beam *Draft * ClearanceType of Clearance Required at ONE°15 Marina Nirup Island *ArrivalDepartureDate of Departure from ONE°15 Marina Nirup Island *Clearance Date *Clearance Time *9:00 AM9:30 AM10:00 AM10:30 AM11:00 AM11:30 AM12:00 PM12:30 PM1:00 PM1:30 PM2:00 PM2:30 PM3:00 PMLast Port of Call *Next Port of Call (after ONE°15 Marina Nirup Island) * Documents SubmissionPlease submit your documents by 6pm if your clearance date is the next day.Registration Number *Registration Expiry Date *Please upload your vessel registration *Max. file size: 64 MB.Insurance Policy Number *Insurance Expiry Date *Please upload your vessel insurance *Max. file size: 64 MB.MMSI/ AIS/ HART Number *Please upload your crew listMax. file size: 64 MB.Please upload your passenger list *Max. file size: 64 MB.AA/ AD Application Number * Please upload your AA/ AD application's IPA approval letter *Max. file size: 64 MB.CIQ Reservation Fee: *Price: $220.00CIQ Reservation Fee: *Price: $330.00CIQ Reservation Fee: *Price: $305.00CIQ Reservation Fee: *Price: $460.00CIQ Reservation Fee: *Price: $0.00Payment Method *Credit card paymentCharge to membership accountPayment Method *Credit card paymentFOMO PayCredit Card Payment *CardName on Card Scan to pay the CIQ Reservation Fee that is reflected above. Once payment is made, please click Submit Reservation. FOMO Check *Check this box if you have made payment via FOMO Pay. E-Wallets accepted here: Submit Reservation
