TECHNICAL PROGRAM COMMITTEE REGISTRATION FORM

Attention Ms. Dwi Booking Date

Abstract Title
AUTHORS DETAILS (FREE CONVENTION ID)
Salutation  Mr.  Ms.
Full Name
Company/University/Affiliatio
n
Mobile Number
E-mail Address
CO-AUTHORS DETAILS (IF
ANY)
1st Co-Author (Get 50% REGISTRANT
Discount) TYPE :
PROFESSIONAL
Name : INAGA Member  IDR 2.000.000
Non Member  IDR 3.500.000
Mobile Number : Lecture  IDR 1.000.000
E-mail Address : Overseas  USD 400
Company/ MEMBER OF INTERNATIONAL ASSOCATION
University/ : IGA  USD 260
Affiliation
GRC  USD 260
Others  USD 260
STUDENT
Domestic  IDR 500.000
Overseas  USD 50
2nd Co-Author (Full Payment REGISTRANT
Fee) TYPE :
PROFESSIONAL
Name : INAGA Member  IDR 4.000.000
Non Member  IDR 7.000.000
Mobile Number : Lecture  IDR 2.000.000
E-mail Address : Overseas  USD 800
Company/ MEMBER OF INTERNATIONAL ASSOCATION
University/ : IGA  USD 520
Affiliation
GRC  USD 520
Others  USD 520
STUDENT
Domestic  IDR 1.000.000
Overseas  USD 100
3rd Co-Author (Full Payment REGISTRANT
Fee) TYPE :
PROFESSIONAL
Name : INAGA Member  IDR 4.000.000
Non Member  IDR 7.000.000
Mobile Number : Lecture  IDR 2.000.000
E-mail Address : Overseas  USD 800
Company/ MEMBER OF INTERNATIONAL ASSOCATION
University/ : IGA  USD 520
Affiliation
GRC  USD 520
Others  USD 520
STUDENT
Domestic  IDR 1.000.000
Overseas  USD 100
TOTAL AMOUNT IDR
*all IDR prices are include 10% VAT USD
PAYMENT DETAILS (Commitment letter and invoice will be sent to you upon your registration form)
PT FASEN CREATIVE QUALITY
Bank Mandiri, KCP Kemang Jakarta Selatan
USD Account :126-00-0602405-2
IDR Account :126-00-0602403-7
Swift Code : bmriidja
Note: Please email back the FORM and PAYMENT RECEIPT to iigce.registration@iigce.com or facsimile to +6221 7191 422
Please return form to:

PT FASEN CREATIVE QUALITY (QUAD EVENT MANAGEMENT)

Jl. Bangka Raya No. 98, Pela Mampang - Mampang Prapatan, Jakarta Selatan 12720
Hunting : +6221 7179
2480
Facsimile : +6221 7191
 422
Email : iigce.registraion@iigce.com