JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Online Reservation
La Piola Cucina Itatliana 線上訂位表單
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Business Hour
- 營業時間 -
12:00-14:30
18:00-22:00
週二、週三公休
Tue & Wed off
Name
*
姓名（中英文皆可）
Your answer
Gender
稱謂（小姐/先生）
Ms.
Mr.
Clear selection
Date
*
用餐日期（週二、三公休) TUE & WED OFF
MM
/
DD
/
YYYY
Lunch
午餐 12:00-14:30
Choose
12:00
12:15
12:30
12:45
13:00
13:15
13:30
Dinner
晚餐 18:00-22:00
Choose
18:00
18:15
18:30
18:45
19:00
19:15
19:30
19:45
20:00
20:15
20:30
Mobile
*
聯絡電話格式請輸入：0900-000-000
Your answer
No. of Guest
*
用餐人數，大於10位或其他可於備註說明。More than 10 ppl or other request, please note in remark.
Choose
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
20+
Email
*
Your answer
Remark
備註事項
Your answer
Check again before submitting.
提交前麻煩確認資料正確！
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of 快樂島嶼有限公司.
Report Abuse
Forms
