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Borang Tempahan Homestay Kuantan
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* Indicates required question
Nama Penuh :
*
Your answer
No. Kad Pengenalan/ No. Passport :
*
Your answer
No. Telefon :
*
Your answer
Alamat :
*
Your answer
Emel (Jika ada) :
Your answer
Tarikh Daftar Masuk :
*
MM
/
DD
/
YYYY
Tarikh Daftar Keluar :
*
MM
/
DD
/
YYYY
Jumlah Tetamu :
*
(Nyatakan jumlah tetamu Dewasa, Kanak-kanak serta Bayi yang akan menginap)
Your answer
No. Kenderaan yang akan didaftarkan:
*
Your answer
Bayaran Deposit Dilakukan Melalui :
*
ATM Transfer
Online Banking
Interbank Transfer
Other:
Tarikh Pembayaran :
*
MM
/
DD
/
YYYY
Time
:
AM
PM
No. Rujukan Pembayaran :
*
Your answer
Maklumat Tambahan :
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