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HOTEL BOROBUDUR
Jalan
Lapangan Banteng Selatan
Jakarta-INDONESIA
Tel.:
(6221) 380-5555
Fax.:
(6221) 380-9595
ROOM RESERVATION
FORM
THE REGIONAL FORUM
JAKARTA, INDONESIA, 3-5 SEPTEMBER 2001
NAME:__________________________________________________________________________________
(Last Name) (First Name)
(Other Name)
INSTITUTION
/ TITLE:_________________________________________________________________
COMPANY/POSITION
: _______________________________________________________________
OFFICE
MAILING ADDRESS : ______________________________________________________________
TEL./FAX
NO : ___________________________________________________________________________
EMAIL
: __________________________________________________________________________________
PASSPORT
DETAILS :
PASSPORT
NO.: _________________________________ PLACE OF ISSUES _______________________
DATE OF ISSUE : ______________
VALID : ______________ NATIONALITY : __________________
DATE/PLACE
OF BIRTH : ________________________________ SEX : ____________________________
ARRIVAL
DATE : ____________________ FLIGHT NO : _______________ ETA : __________________
NUMBER
OF ROOM : _________________________________ TYPE : ____________________________
REMARKS
: ______________________________________________________________________________
PLACE / DATE : ________________________________
SIGNATURE : __________________________________
- Room
Reservation Form should be returned by facsimile (62-21) 386-5152
Attn.
Ms. Lisa Medianti (Tel. 62-21) 380-5555 ext. 74007).
THE REGIONAL FORUM
“BUSINESS OPPORTUNITIES AND SUSTAINABLE DEVELOPMENT
–
PARTNERSHIP STRATEGIES”
JAKARTA, INDONESIA, 3-5 SEPTEMBER 2001
A T T E N D A
N C E F O R M
N A M E :
________________________________________________________________________________
(Last Name) (First Name)
(Other Name)
- Please
indicate your attendance in the Regional Forum as a speaker, chair
or participant.
INSTITUTION
/ TITLE : _________________________________________________________________
COMPANY
/ POSITION : __________________________________________________________________
OFFICE
MAILING ADDRESS : ___________________________________________________________
TEL./FAX
NO : ___________________________________________________________________________
EMAIL
: ________________________________________________________________________________
PASSPORT
DETAILS :
PASSPORT
NO.: _________________________________ PLACE OF ISSUES _____________________
DATE OF ISSUE : ______________
VALID : ______________ NATIONALITY : __________________
DATE/PLACE
OF BIRTH : ________________________________ SEX : __________________________
ARRIVAL DATE : __________________
FLIGHT NO. ________________ ETA : ___________________
SIGNATURE
: ____________________________ PLACE / DATE : ________________________________
NOTE
:
To facilitate hotel reservations, participants are
requested to complete and submit the attached Room Reservation Form
at an early date and send directly both to the Hotel and to the designated
official of the Organizing Committee, Ms. Retno L.P. Marsudi or Mr.
Winardi Hanafi Lucky (Fax. (62-21) 385-7315).
The Room Reservation Form should be sent before
August 29, 2001 with credit card guarantee. Due to the tourist peak
season, reserved rooms allocated by the Organizing Committee can only
be guaranteed until that date.
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