Registration Form Sept... - yimg.com

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Dates. : September 14-15, 2012, Friday-Saturday. Venue. : SBTH BOUTIQUE HOTEL ,jl. Sangga buana no 13, Bogor. Course Leader. : Genta Hariangbanga, S.T.
REGISTRATION FORM Training Program Dates Venue Course Leader Tuition Fee

: : : : :

Facilities

: - Hardcopy and Softcopy Hands-Out - Convenient Meeting Room and Facilities - Meals and two-times refreshment - Certificate of Appreciation - Souvenir ( Soil amendment material) - Field training - Demonstration

Soil Amendment using Polymers and Bio-Organic Technology

September 14-15, 2012, Friday-Saturday SBTH BOUTIQUE HOTEL ,jl. Sangga buana no 13, Bogor. Genta Hariangbanga,S.T Rp. 6.000.000,- for 1 person, Rp. 11.500.000,- for 2 person

Attendee Name : _________________________________________________ Company

: _________________________________________________

Phone/Fax

: _________________________________________________

E-mail address : _________________________________________________ Mobile Phone

: _________________________________________________

Contact Person : _________________________________________________ METHOD OF PAYMENT By Cash on the date of arrival By Transfer before seminar held

All cheques and transfer payable to: PT. GREEN EARTH INDONESIA BANK NIAGA Cabang Bogor. A/C 054.01.12630.00.0 (Rp.) Please return this form together with payment statement before September 7 , 2012 to the: PT.GREEN EARTH INDONESIA BUKIT CIMANGGU CITY BLOK T5-23 Phone/Fax: 0251-753 9082 E-mail: [email protected]