Sign Up Form
The project is the collaboration of universities from different countries. Please note that after you submit this form, you will agree to commit and participate to the Nusantara Worldwide Collaboration Project. There are only limited seat so if you are not sure please don't submit this form. To reserve your seat, please fill out the information below.
First name *
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Last Name *
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Email Address (please using your institution/university email if possible) *
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Phone
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Reasons to join the project *
Profile of Participant *
If you are lecturer, university where you will be teaching the course(s), please write the full name the way it should appear on all official documentation
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If there are more than one instructors (or graduate students) responsible for the course, please provide the contacts of the additional instructors here. All people listed here will receive copies of all correspondence.
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Department/ Faculty *
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Name of the course in which this project will be integrated *
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Address/City of institution *
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Number of your students (jumlah mahasiswa yg akan berpartisipasi) *
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Semester start *
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Semester end *
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Do your students will visit the case study company in Indonesia? *
We expect students can visit the company and present the result in front of the management. Students do not only gain consultancy experience but also learn other cultures
When you can submit your students' list? *
In order to participate in this project, you need to submit the student's list
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