ASAIHL 2013 Online Registration
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Registration
Non Member Fee
- Foreign participants: US$200 (includes conference kit, airport transfer, snack, lunch and cocktails)
- Local participants: IDR 1.000.000,00 (includes conference kit, airport transfer, snack, lunch and cocktails)
- Student: Free Registration fee ( The quota is 25 international students and 25 local students )

Member Fee
-Free registration fee, up to 3 participants for each university member (please check at your university about their status membership). The additional participants will have to pay the registration fee.
- Student: Free Registration fee ( The quota is 25 international students and 25 local students )
For local payments, please refer to the following bank details:
Name: Rektor Unair
Account No. 0215727352
Bank: BNI Cab. Surabaya

For foreign payments, please refer to the following bank details:
Name: Universitas Airlangga
Account No. 141.00.07105323
Beneficiary Bank: Bank Mandiri
Bank address: Bank Mandiri cabang Unair
Bank international code: BMRIIDJA
PERSONAL DETAILS
Title *
(example: Prof., Dr., Mr.,Ms.)
First Name *
Middle Name
Last Name *
Passport Number/ ID Number *
INSTITUTION
Institution Name
Is Your Institution an ASAIHL Member? *
Required
Are you attending as… *
Required
Position in the Institution
(e.g.: Rector, Lecturer, Student)
Address *
City *
State/Province *
Zip/Postal *
Country *
Telephone Number *
(Example: +66 2 579-1111)
Your E-mail Address *
REGISTRATION :
Arrival Date : *
Flight Number : *
Hotel Name :
Addition :
Would you like to participate city tour?
* Additional fee required
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