Bumi Surabaya Hotel Reservation Form Full Name * Email Address * Phone Number *(WhatsApp number is preferred) Number of Room(s) *Number of Room1 Room2 Rooms3 Rooms Total of Night(s) *Total of Night(s)1 night2 nights3 nights4 nights5 nights6 nights7 nights8 nights9 nights10 nightsState how many nights you will reserve the room Check-In Date * Check-Out Date * Room Type – Classic Room (Special IKARGI Symposium Rates: IDR 879.000/night) *Classic Double Bed RoomClassic Twin Bed Room*A 42-square-meter classic room includes breakfast for 2 people and tax Total Invoice Amount Rp. (Total Amount to Be Paid) Payment Transfer BankBRI (Bank Rakyat Indonesia)No. Account 0580-01-000495-56-4a/n Simposium Nasional IKARGI XII Surabaya Upload Proof of Payment * Choose FileNo file chosenDelete uploaded file Special Notes or Requests (if any)The committee will make every effort to fulfill all your requests and additional notes; however, we cannot guarantee that they will be accommodated, as it depends on the prevailing situation and conditions. Consent * All funds paid to the committee are non-refundable for any reason, except in the event of cancellation or other force majeure conditions. I have read and agree to this statement. SUBMIT