Beruflich Dokumente
Kultur Dokumente
Industry Training
That Held Back To Back With
5th ASEAN Medical Device Committee Meeting
and
Its Related Meeting
Quality Agreement and Warehousing Management Root Cause Analysis, Risk Analysis, and CAPA
REGISTRATION FORM
Registration Details
Name (*Mr/Mrs) : __________________________________________________________________________
Company / Organization : __________________________________________________________________________
Title : __________________________________________________________________________
Foreign Corporation, Indonesian MNC Non GAKESLAB/ASPAKI Member USD 650,- / Person
Note :
1. IDR 1.000.000,- (Local) or USD 100 (Foreigner) discount for Early Bird Registration by August 17th, 2017
2. IDR 4.000.000,- Registration Fee for 3rd person of same local companies (BUMN, GAKESLAB/ASPAKI Member)
3. IDR 5.000.000,- Registration Fee for 3rd person of same Indonesian companies non GAKESLAB/ASPAKI Member
4. Registration Fee Covers 2 days Training (4th & 5th October 2017) and Gala Dinner (4th October 2017)
I Would also like to Join Bromo Tour (*OPTIONAL)
PAYMENT METHODE :
Transfer Bank
IDR Currency USD Currency
Bank Name : Bank Central Asia Bank Name : Bank Central Asia
Account Name : Nicky Johan Cahyono Account Name : Nicky Johan Cahyono
Note :
All banking charges, if any, are to be borne by the delegates
Please quote the 5th AMDC Meeting in the remittance document as the remittance message for our
Verification. Please submit the completed registration form together with the copy of remittance document
to: 5thamdccommittee@gmail.comOr email to ivanchristiawan@gmail.com
Important Note:
Registration fee is nonrefundable.
Meeting program is subject to change without prior notice.
The information provided in this form will only be used for processing your participation and
Communication with you on matters related to the 5thAMDC Meeting. If you wish to correct your personal
data, please email to 5thamdccommittee@gmail.com
Any copy of telegraphic transfer should be sent to 5thamdccommittee@gmail.com
Date