Intake form

Help us serve you better

Name *

Email address *

What type of accommodation are you interested in?

What amenities are important to you?

Please select at least one option.

Wi-Fi

Air Conditioning

Laundry Services

Kitchen Access

Parking

What is your preferred check-in date?

What is your preferred check-out date?

How did you hear about us?

What is your budget range per month?

Do you have any special requests or preferences?

Additional questions or comments

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Permi Indah Kost