Registration Form (Formulir Pendaftaran)
Please fill this registration form in a valid and active your Mobile Phone/WhatsApp Number or Email (Mohon mengisikan formulir registrasi ini menggunakan Nomor HP/WA atau email yang valid dan aktif digunakan)
For more information please contact us (Apabila memerlukan informasi mohon hubungi):
- Email : Contact@DEFINIT.Asia
- WA/Telp : 0822-9229-8448
* Required
Email address
*
Your email
Full Name (Nama Lengkap)
*
You may add educational degree or certification (e.g. Ph.D or MSc); (Beserta gelar, jika ada)
Your answer
Institution Name (Nama Lembaga)
*
Your answer
Abreviation of Institution Name (Singkatan Nama Lembaga)
*
Your answer
Position (Jabatan)
*
Your answer
Please describe your job in a brief (Mohon deskripsikan secara singkat pekerjaan Anda)
*
Your answer
Office Address (Alamat Kantor)
Your answer
Office Phone Number (Nomor Telepon Kantor)
*
Your answer
Mobile Phone/WhatsApp Number (Nomor HP/WhatsApp)
*
Your answer
Please tick the workshop you wish to attend (you may choose both or one of the events) / Workshop yang ingin diikuti (Dapat memilih dua event sekaligus) - Total Limited Seat 100 per event
*
01 September 2020
02 September 2020
Required
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