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Survey Form September Flights from Jakarta
This survey form will be used by PAL for application of repatriation flight in case the travel ban from Indonesia will be extended in the month of September
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* Indicates required question
Email
*
Your email
Last Name
*
Your answer
First Name
*
Your answer
Middle Name
*
Your answer
Suffix (i.e. jr.)
*
Your answer
Nationality
*
Filipino (PH Passport Holder)
Indonesian
Other:
Booking Reference: (6 character) if already have a ticket
Your answer
Flight date or preferred flight date for September
*
September 12 or 13
September 26 or 27
Passport Number
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Gender
*
Male
Female
Prefer not to say
Classification
*
Land Based OFW
Seafarer
Returning Filipino
Diplomats or PH govt officials
Non Filipino
Medical Condition? (pregnant, wheelchair passengers, etc?
Your answer
For OFWs - OWWA/OFW / KITAS No. (dependents travelling together with the OFW follows the number of the OFW)
Your answer
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