No.002_ _ _ No.

002_ _ _

REGRISTRATION FORM REGRISTRATION FORM

Formulir Registrasi Formulir Registrasi
PLEASE WRITE IN BLOCK LETTER PLEASE WRITE IN BLOCK LETTER

Datang Tgl Datang Dari Berangkat Tgl No. Penerb. Pergi Ke Datang Tgl Datang Dari Berangkat Tgl No. Penerb. Pergi Ke
Arrival date: Coming from: Departure date: Flight No: To Destination Arrival date: Coming from: Departure date: Flight No: To Destination

Nomor Kamar Jenis Kamar Harga Kamar Pembayaran Uang dimuka Nomor Kamar Jenis Kamar Harga Kamar Pembayaran Uang dimuka
Room Number: Room Type: Room Rate: Advance Deposit: Room Number: Room Type: Room Rate: Advance Deposit:

Nama Belakang Nama Depan Nama Belakang Nama Depan

Family/Last name: First name: Family/Last name: First name:

Kebangsaan Tempat dan Tanggal Lahir KTP/Paspor No Kebangsaan Tempat dan Tanggal Lahir KTP/Paspor No
Nasinality: Date & Place of Birth: Identity Card Number: Nasinality: Date & Place of Birth: Identity Card Number:

Nomor Telepon/HP Alamat Surat Elektronik Nomor Telpon Darurat Nomor Telepon/HP Alamat Surat Elektronik Nomor Telpon Darurat
Phone Number: E-mail Address: Urgent Phone Number: Phone Number: E-mail Address: Urgent Phone Number:

Pekerjaan Nama Perusahaan Maksud Kedatangan Pekerjaan Nama Perusahaan Maksud Kedatangan
Profession: Name of Company: New Arrival: Profession: Name of Company: New Arrival:

Alamat Rumah Tinggal Alamat Rumah Tinggal

Home Address: Home Address:

Cara Pembayaran Yang Digunakan Cara Pembayaran Yang Digunakan

Form of Settlement Form of Settlement

Cash/Tunai Vouchers Other Credit Card Visa Cash/Tunai Vouchers Other Credit Card Visa

BCA BCA
BNI BNI
Master Master
Money, Jewels dan other Valuables must be placed in the hotel savety Tanda Tangan Tamu Money, Jewels dan other Valuables must be placed in the hotel savety Tanda Tangan Tamu
box, otherwise the Management WILL NOT be responsible for any loss. Guest of Signature box, otherwise the Management WILL NOT be responsible for any loss. Guest of Signature
Signature authories after departure billing indicated in method of Signature authories after departure billing indicated in method of
payment. payment.
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Petugas Front Office Petugas Front Office

Front Office Clerk Initial:___________________________________ Front Office Clerk Initial:___________________________________