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Secretariat Asia Africa Smart City Summit 2015:
Contact Person : 1. Emil Fahmi Yakhya
2. Liza Handayani
Phone
: +62 22 4232338-39/69
Fax
: +62 22 4234892
Email
: [email protected]
Please fill in with block letters and forward by email or fax before 17 th April 2015.
I need an Invitation Letter from the committee for Visa Arrangements (for international participants only)
For Secretariat Only
Date
Reg. No
PERSONAL INFORMATION
Country
Name (Mr, Mrs, Ms)
Name of Accompanying Person
Delegation
Upload Your Picture
Government & City Council Official
Industry
Academicians
Accompanying Person
ORGANIZATION/INSTITUTION INFORMATION
Name
Position
Address
Phone Nos.
Mobile:
Office:
Fax:
Email Address
FLIGHT INFORMATION
ARRIVAL
Soekarno Hatta International Airport
Husein Sastranegara International Airport
Flight No.
DEPARTURE
Soekarno Hatta International Airport
Husein Sastranegara International Airport
Flight No.
SHUTTLE BUS
Arrival
Soekarno Hatta International Airport to The Trans Luxury Hotel Bandung
21 April 2015 :
10.00
14.00
18.00
20.00
00.00
22 April 2015 :
08.00
10.00
12.00
Husein Sastranegara International Airport to The Trans Luxury Hotel Bandung
21 April 2015 : 08.00 – 00.00 (Every Hour) Time ……..
22 April 2015 : 08.00 – 18.00 (Every Hour) Time ……..
ACCOMMODATION
Check In – Check Out
Room Type
Date (dd/mm)/ Time
Date (dd/mm)/ Time
Departure
The Trans Luxury Hotel Bandung to Soekarno Hatta International Airport
24 April 2015 :
04.00
12.00
Departure to Soekarno Hatta International Airport: 7 hours before the flight schedule
The Trans Luxury Hotel Bandung to Husein Sastranegara International Airport
24 April 2015 : 06.00 – 22.00 (Every Hour) Time ……..
Departure to Husein Sastranegara International Airport: 3 hours before the flight
(dd/mm-dd/mm)
TWIN
SINGLE
Hotel Ibis Bandung Trans Studio – 3* (0 km from venue)
Number of Night
SMOKING
NO SMOKING
The Trans Luxury Hotel Bandung – 5* (0 km from venue)
Room Type/Rate
Standard Room (Rp. 700.000,-/room/night)
Room Type/Rate
Premier Room (Rp. 2.843.500,-/room/night)
Premier Room (Rp. 3.872.000,-/room/night)
Contact Person
Eva Petra
P. +62 22 8734 5555; F. +62 22 8734 7777
E. [email protected]
Contact Person
Agnes Chungafarmodjo
P. +62 22 8734 8888; F. +62 22 8734 9999
E. [email protected]
 To secure the room availability, participants are requested to fill in the attached Form not later than 17 April 2015, and send directly to the respective hotel with a copy to
Secretariat Asia Africa Smart City Summit.
 1st night non-refundable deposit payment is required upon reservation to confirm the booking and paid directly to the hotel.
 Any cancellations and booking changes should be sent in writing by fax or email directly to the designated Hotel prior to arrival.
 Payment by credit card is normally charged in local currency. The subsequent exchanges rates might be applied by the credit card vendors, when your statement is converted
into local currency.
 All room rates offered include daily breakfast and 21% relevant government tax & service charges.
 Organizing committee provides airport transfer to official hotel v.v. on April 21st, 22nd,23rd and 24th 2015.
TYPE OF ACCOMMODATION PAYMENT
Type of Card
VISA
Master Card
Name of Card Holder
Credit Card Number
Expire Date
Authorized Amount
Card Holder Signature
PLEASE KEEP A COPY OF YOUR RECORD
1. All Rooms are on 1st-serve basis. Please book your room immediately or not later than 17 April 2015.
2. Participant are requested to complete and return this Form directly to the selected hotel. Please ensure you receive the hotel confirmation of your booking from the
hotel.
Signature _____________________________
(with company stamp)
Date: _____________________________