Postal Address :

COUNCIL OF CHURCHES OF MALAYSIA Council of Churches of Malaysia,

No. 26, Jalan Universiti,
46200 Petaling Jaya,
ECUMENICAL CENTER Selangor D.E., Malaysia.
Tel : +603-79567092 / 79551587
ROOM RESERVATION FORM Fax :+603-79560353
Email : ccm_oikoumene@yahoo.com

NAME :……………………………………………………………………………………………

MY KAD NO./PASSPORT NO. :………………………………………………………………….

ADDRESS :………………………………………………………………………………………...

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CONTACT NO. : OFFICE/HOME :……………………………………………………………..

H/PHONE :……………………………………………………………..

EMAIL ADDRESS :…………………………………………………………...

NATIONALITY :…………………………………………………………………………………

CAR REGISTRATION NO. :……………………………………………………………………...

CHURCH/ORGANIZATION :…………………………………………………………………….
ROOM TYPE NO. OF ROOMS CHECK IN CHECK OUT TOTAL
REQUIRED DATE DATE NIGHTS
SINGLE (RM 75.00) 1 18th Aug 20th Aug 2
TWIN (RM 105.00) 1 18th Aug 20th Aug 2
SUITE (RM 155.00) 3 18th Aug 20th Aug 2

TOTAL COST (RM): ……………………….

MODE OF PAYMENT – CASH/CHEQUE :……………………………………………………

I/We knowing that this is a Christian Organization, agree to abide with all Rules and Regulations
governing this facility.

………………………………………………. …………………………….
SIGNATURE DATE
OFFICE USE
ROOM NO.ASSIGNED : CASH/CHEQUE RECEIVED
RM …………………………….

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CASHIER’S NAME :
Note : Cheques not acceptable unless prepaid and cleared in advance.
Cheques to be made payable to : Council of Churches of Malaysia Ecumenical Center
Public Bank A/C NO : 3185786611
Reservation Deposit and Payment: 50% of the total amount and balance to be paid upon check-in.
All bank-in slips to be faxed or emailed (ccm_oikoumene@yahoo.com).