ࡱ> TVS'`  bjbj"9"9 J@S@S jjjjjjj4DFm".vD[$!!!!!!!$#h&h"j@@@"jj'"444@jj!4@!44tjj d ="0m",k&Fk&k&jXZ@44M""* m"@@@@d jjjjjj  IOC UNESCO 9th Session of the Intergovernmental Coordination Group for the Indian Ocean Tsunami Warning and Mitigation System (ICG/IOTWS-IX) Jakarta, Indonesia, 27 - 30 November 2012 Hotel Reservation Form Please complete this form and return before October 25th, 2012 to the local organiser at BMKG Attn : Dr. Wandono or Mrs. Titi, e-mail : HYPERLINK "mailto:inatews.secretariat@yahoo.com" \hinatews.secretariat@yahoo.com and cc to UNESCO office Jakarta :  HYPERLINK "mailto:l.martin-diez@unesco.org" l.martin-diez@unesco.org Name :  FORMCHECKBOX  Mr. /  FORMCHECKBOX  Ms. /  FORMCHECKBOX  Dr. /  FORMCHECKBOX  Prof. First name : ____________________ Middle name : ____________________ Last name : ____________________ (should appear as in passport) Sex :  FORMCHECKBOX  Male  FORMCHECKBOX  Female Contact Details : Country : ______________________________________________________________________ Organization : ______________________________________________________________________ Address : ______________________________________________________________________ ______________________________________________________________________ Telp. (office) : ___________________________ Telp. (office) : __________________________ E-mail : _____________________________________________________________________ Flight Confirmation : Date of Arrival : _______________________________________________________________ Flight Number : _________________ Time of Arrival : ________________________________ Date of Departure : _______________________________________________________________ Flight Number : _________________ Time of Departure : _____________________________ Passport Number : _______________________________________________________________ Expiry Date : _______________________________________________________________ Hotel Reservation : BMKG will arrange participants to stay at Borobudur Hotel or Aryaduta Hotel. Hotel reservation will be made by BMKG. Please choose ( the room type you wish to stay. Borobudur HotelRoom TypeCorporate Rates1.  FORMCHECKBOX  Premier DeluxeIDR 1,036,000,- nett2. FORMCHECKBOX  ExecutiveIDR 1,350,000,- nettOne US Dollar is approximately IDR/RP 9,560,- (as per 14 September 2012) Aryaduta HotelRoom TypeCorporate Rates1.  FORMCHECKBOX  SuperiorUS $ 75,- nett2. FORMCHECKBOX  DeluxeUS $ 85,- nett3. FORMCHECKBOX  Superior ClubUS $ 95,- nett4. FORMCHECKBOX  Deluxe ClubUS $ 105,- nett5.  FORMCHECKBOX  Signature Superior ClubUS $ 135,- nett6. FORMCHECKBOX  Signature Deluxe ClubUS $ 145,- nett5.  FORMCHECKBOX  Junior SuiteUS $ 160,- nett6. 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