Name :

Class :
Material : Fill out the form

Look at this form and answer the questions by choosing a, b, c, d, or e.

1. What do you call this kind of form….

A. Order form
B. Medical form
C. Deposit slip
D. Withdrawal slip
E. Reservation form

2. Why did Wayne have to fill out this form….

A. He had to fill out this form because he wanted to reserve a place.
B. He had to fill out this form because he wanted to take some money.
C. He had to fill out this form because he wanted to order things
D. He had to fill out this form because he wanted to make an account
E. Because he wanted to transfer some money.
3. What would happen if he didn’t fill out this form…
A. He couldn’t withdraw some money
B. He can withdraw some money
C. He can’t withdraw some money
D. He couldn’t reserve a place
E. He couldn’t order a things

4. How much did Wayne withdraw from his savings….

A. He withdrew $150 from his savings
B. He withdraw $ 60 from his savings
C. He withdraw $ 400 from his savings
D. He withdrew $ 350 from his savings
E. He withdrew $ 320 from his savings

5. When did Wayne withdraw his money from the bank…

A. He withdrew his money on March 23, 2017

B. He withdrew his money on March 23, 2018
C. He borrow the money on March 23, 2018
D. He lend his money on March 23, 2018
E. He save his money on March 23, 2018
6. Why did Anne Laurence complete this form…

A. To apply for a designer’s job

B. To win an award
C. To enroll in a design course
D. To receive magazines
E. To send magazines

7. How much is the full cover price for each issued…

A. Rp. 30.000,-
B. Rp. 288.000,-
C. Rp. 20.000,-
D. Rp. 24.000,-
E. Rp. 300.000,-
8. How long will it take for the first issue to be delivered…

A. One month
B. Four month
C. Two weeks
D. One week
E. One year

9. The magazine comes….

A. Daily
B. Weekly
C. Monthly
D. Every three months
E. Every six months
1. Hi, my name is Mark Peterson. Just call me Peter.
2. Excuse me. What’s your last name?
3. What do you do?
4. Where do you live?
5. Could I have your phone number, please?
6. Where were you born?
7. Sure. It’s 022-7833626
8. I am a secretary.
9. Nice to meet you, Peter. I am Richard Burner. But please call me Richard.
10. I was born in Sydney.
11. I live at 12 Tebu Ireng Street.
12. It’s Burner.

10. Arrange the jumbled sentences above to make good dialogues……

A. 1 – 9 – 2 – 12 – 3 – 8 – 4 – 11 – 5 – 7 – 6 – 10
B. 1 - 10 – 2 – 12 – 3 – 11 – 4 – 9 – 5 – 7 – 6 – 8
C. 1 – 2 – 3 – 4 - 5 – 6 – 7 – 8 – 9 – 10 – 11 - 12
D. 9 – 1 – 12 – 2 – 8 – 3 – 3 – 11 – 7 – 5 – 10 – 6
E. 12 – 1 – 11 – 2 – 10 – 3 – 9 – 4 – 8 – 5 – 7 – 6

Essay !

1. Information 2. Create a purchase form based on the

Danias Haryanto is in the bank now to withdraw some following situation. (Buat
money from his savings account (999-0723-5577) menggunakan aplikasi Canva)
12/03/2020
a. Mitra Kukar company, located on
Saving accounts
He wants to withdraw about Five hundred thousand 23 Paskal ,Jakarta, on 13 August
rupiah 2017 purchased some mathematic
Enter signature and full name. books from PT. CERDAS BANGSA
which located at 8 Burangrang,
Fill out this form with information that given above. Bandung, Jawa Barat.
Metro saving banks b. The books are the following:
Date : No. B 207139 - 50 copies of “Cara Berhitung
Cepat” Otong Kusdinar
Account Number : @50,000
Name of account holder : - 20 copies of “ Bank Soal
Account type : Saving Matematika Dasar “ @25,000
Checking accounts
- 27 copies of “ Stategi Mengajar
Amount :
Matematika SMA” @17,500
In Words : c. Include 40% discount. Delivery
cost Rp 115,000 and packing
charge Rp27,000.
Teller’s Signature Depositor’s signature The goods are sent via JNR express
Indo Envelop