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Arrival Information Form
Blanko Informasi Kedatangan
our services


Please fill this form for our information.
(Silakan mengisi blanko di bawah ini sebagai informasi buat kami.)

Name (nama) :
Sex (jenis kelamin) : Male/Laki-laki Female/Perempuan
Address (alamat) :
State & Country (negara) : ZIP (kode pos)
Number of person
(jumlah yg datang) :
1 2 3 4 5 6 more than 6
If more than 1, please type name and sex of the others in text area bellow :
(bila lebih dari satu, tolong ketik nama/jenis kelamin yang lainnya dlm kotak di bawah ini)
Planned arrival (rencana kedatangan) : date/tgl month/bln year/thn
Arrival place (tempat kedatangan) : Railway station "Baranangsiang" bus station
Approximate arrival time (perkiraan waktu kedatangan) : hour/jam minutes/menit am/pm
You want us to pick up (ingin dijemput ?) : Yes/ya No/tidak
You want to be booked room/s (ingin dipesankan kamar ?) : Yes/ya No/tidak
If Yes (bila ya) :
single room/s
double room/s
class/kelas
stay duration/lama tinggal :
from date/month (tgl/bln) till (s/d)
Any message/
suggestion/comment ?
(ada pesan ?) :





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