Registration form for Chaine Gala Dinner to be held on the 2nd of April at the Raffles Hotel in Jakarta, Indonesia.

1. CHAPITRE GALA DINNER
Tuesday, 2nd
April 2019
Djakarta Room at Raffles Hotel
Mega Kuningan – Jakarta
Induction Ceremony 05.45 pm
Cocktail starts at 06:45 p.m. / Dinner starts at 07:45 p.m.
Dress Code: Black Tie for Gents and Cocktail Dress or Evening Gown for Ladies
Contribution to the Meal for Member OR Spouse : IDR 1,600,000,- nett
Contribution to the Meal for Non Member OR Guest : IDR 1,900,000,- nett
Dinner contribution inclusive wines, tax, service charge & charity contribution
R E S E R V A T I O N
Member (1,600,000):
Spouse (1,600,000):
Non-Member 1 (1,900,000):
Non-Member 2 (1,900,000):
Total number of people: Total due: IDR.
P A Y M E N T
Note: Reservation will NOT be accepted without receipt of the corresponding payment.
Booking will be released without notice, if payment is not received by 29th
March.
Cancellation Policy:
Cancellations are strictly accepted only via fax/email
ON or BEFORE Friday, 30th
March 2019 by 12 noon.
Strictly No refund after the date and time mention above
By BANK TRANSFER
To the account noted on the right:
Please include the following reference in the transfer message:
Chaine 2nd
Apr + member’s family name
Please complete and return this form including your payment guarantee by email (sign, scan,
send) or fax to: Fabrice Mini/Renny Situmorang at chaine.jakarta@gmail.com
cc to : Alistair G. Speirs at speirs@phoenix.co.id and Fabrice Mini at Fabrice.MINI@accor.com
or fax to: 021-5744405
Bank : BCA
Kantor Cabang : Gunung Sahari
Account# : 212-280-4560
Account Name : Mini Fabrice Noel
Emmanuel