PARTICIPATION FORM
 

Name of Company

:

......................................................................

Contact Person

:

......................................................................

Address

:

......................................................................

......................................................................

......................................................................

Phone/Fax

:

......................................................................

Email

:

......................................................................

 

Interested to participate in form of (please choose): 
Financing the program as:

Membership A-Rp. 800,000/month

Membership B-Rp. 400,000/month


Payment term through:

Bank transfer

Check

Cash

Other