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TRAINING REGISTRATION FORM

EMAIL/FAX

To:
PT Trakindo Utama Cileungsi Training Center
Jl. Narogong Raya Km. 19 Cileungsi
Bogor 16820
Fax
: 021 8233360
Phone : 021 8233361
Email : wahid.abdurakhman@trakindo.co.id
Herewith I would like to register :
Name(s)
1 .................................................................................
2 .................................................................................
3 .................................................................................
4 .................................................................................
5 .................................................................................
6 .................................................................................
7 .................................................................................
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12 ...............................................................................
To attend the training
Training Title
Date
Vanue

Use Accommodation*
Yes / No (circle one)
Yes / No (circle one)
Yes / No (circle one)
Yes / No (circle one)
Yes / No (circle one)
Yes / No (circle one)
Yes / No (circle one)
Yes / No (circle one)
Yes / No (circle one)
Yes / No (circle one)
Yes / No (circle one)
Yes / No (circle one)

: ...........................................................................................................................
: ...........................................................................................................................
: Pekanbaru / Cileungsi / Balikpapan (circle one)

Customer Information (Important)


Please send the invoice to (must be filled with accurate data):
CompanyName
Address

AccountingContact
Phone

Email

:.............................................................................
:.............................................................................
.............................................................................
.............................................................................
:.............................................................................
:.............................................................................
:.............................................................................
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Name & Company Stamp


*) Accommodation will be provided (if available) when training conducted at Cileungsi Training Center

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