var date = new Date();
var year = date.getFullYear();

var     str ='<tr>'; 
        str +='<td >Check in: </td>';
         str +='<td colspan="3">';
      str +='<select name="gcid">';
          str +='<option>------'; 
          str +='<option value="1">1'; 
          str +='<option value="2">2'; 
          str +='<option value="3">3'; 
          str +='<option value="4">4'; 
          str +='<option value="5">5'; 
          str +='<option value="6">6'; 
          str +='<option value="7">7'; 
          str +='<option value="8">8'; 
          str +='<option value="9">9'; 
          str +='<option value="10">10'; 
          str +='<option value="11">11'; 
          str +='<option value="12">12'; 
          str +='<option value="13">13'; 
          str +='<option value="14">14'; 
          str +='<option value="15">15'; 
          str +='<option value="16">16'; 
          str +='<option value="17">17'; 
          str +='<option value="18">18'; 
          str +='<option value="19">19'; 
          str +='<option value="20">20'; 
          str +='<option value="21">21'; 
          str +='<option value="22">22'; 
          str +='<option value="23">23'; 
          str +='<option value="24">24'; 
          str +='<option value="25">25'; 
          str +='<option value="26">26'; 
          str +='<option value="27">27'; 
          str +='<option value="28">28'; 
          str +='<option value="29">29'; 
          str +='<option value="30">30'; 
          str +='<option value="31">31';
      str +='</select>';
      str +='<select name="gcim">';
          str +='<option>------ </option>';
          str +='<option value="1">Januari</option>';
          str +='<option value="2">Februari </option>';
          str +='<option value="3">Maret</option>';
          str +='<option value="4">April </option>';
          str +='<option value="5">Mei </option>';
          str +='<option value="6">Juni </option>';
          str +='<option value="7">Juli</option>';
          str +='<option value="8">Agustus</option>';
          str +='<option value="9">September </option>';
          str +='<option value="10">Oktober </option>';
          str +='<option value="11">November </option>';
          str +='<option value="12">Desember </option>';
          str +='</select>';
      str +='<select name="gciy">';

          for (i=year; i<=year+4; i++) {
            str +="<option value=\""+i+"\">"+i+"</option> \n";
          }

      str +='</select>';
     str +='</td>';
        str +='</tr>';
        str +='<tr> ';
         str +='<td >Check out:</td>';
         str +='<td colspan="3">';
      str +='<select name="gcod">';
          str +='<option>------'; 
          str +='<option value="1">1'; 
          str +='<option value="2">2'; 
          str +='<option value="3">3'; 
          str +='<option value="4">4'; 
          str +='<option value="5">5'; 
          str +='<option value="6">6'; 
          str +='<option value="7">7'; 
          str +='<option value="8">8'; 
          str +='<option value="9">9'; 
          str +='<option value="10">10'; 
          str +='<option value="11">11'; 
          str +='<option value="12">12'; 
          str +='<option value="13">13'; 
          str +='<option value="14">14'; 
          str +='<option value="15">15'; 
          str +='<option value="16">16'; 
          str +='<option value="17">17'; 
          str +='<option value="18">18'; 
          str +='<option value="19">19'; 
          str +='<option value="20">20'; 
          str +='<option value="21">21'; 
          str +='<option value="22">22'; 
          str +='<option value="23">23'; 
          str +='<option value="24">24'; 
          str +='<option value="25">25'; 
          str +='<option value="26">26'; 
          str +='<option value="27">27'; 
          str +='<option value="28">28'; 
          str +='<option value="29">29'; 
          str +='<option value="30">30'; 
          str +='<option value="31">31';
      str +='</select>';
      str +='<select name="gcom">';
          str +='<option>------ </option>';
          str +='<option value="1">Januari</option>';
          str +='<option value="2">Februari </option>';
          str +='<option value="3">Maret</option>';
          str +='<option value="4">April </option>';
          str +='<option value="5">Mei </option>';
          str +='<option value="6">Juni </option>';
          str +='<option value="7">Juli</option>';
          str +='<option value="8">Agustus</option>';
          str +='<option value="9">September </option>';
          str +='<option value="10">Oktober </option>';
          str +='<option value="11">November </option>';
          str +='<option value="12">Desember </option>';
          str +='</select>';

      str +='<select name="gcoy">';
      
          for (i=year; i<=year+4; i++) {
            str +="<option value=\""+i+"\">"+i+"</option> \n";
          }

      str +='</select>';

     str +='</td>';
     str +='</tr>';

document.write(str);