REGISTRATION FORM

Sekolah Cikal Cultural Exchange Program 2018

This is to confirm that I give permission for my child to join the CEP Korea 2018 and agree to the
terms of condition that the program requires.

Student’s name : ______________________________________________________________

Class 2017/2018 : ______________________________________________________________
School email : ______________________________________________________________
Date of birth : ______________________________________________________________
Passport expired date : ______________________________________________________________

Parent’s name : ______________________________________________________________

Phone number : ______________________________________________________________
Email : ______________________________________________________________

The program FEE is 20.500.000 IDR

 1st payment : Feb 10, 2018 : 5.500.000 IDR
 2nd payment : March 10, 2018 : 6.000.000 IDR
 3rd payment : April 10, 2018 : 6.000.000 IDR
 4th payment : May 10, 2018 : 3.000.000 IDR

Jakarta, ________________________________

______________________________
Parents’s name