Formulir Penulisan Makalah KRTJ 13

HIMPUNAN
PENGEMBANGAN
JALAN INDONESIA
(HPJI)

KONFERENSI
REGIONAL TEKNIK
JALAN KE-13
(KRTJ-13)

FORMULIR PENDAFTARAN
Aplikasi Penulisan Abstrak & Makalah Teknik
PENYELENGGARA : DPP & DPD HPJI PROVINSI SULAWESI SELATAN
SEKRETARIAT PANITIA KRTJ-13/SEKRETARIAT DPP HPJI
Graha Iskandarsyah Lt.4, Jl. Iskandarsyah Raya 66C, Kebayoran Baru, Jakarta 12160
Telp. 6221-7251864, Facs. 6221-7208112, E-mail : krtj13makassar@gmail.com Website : http//www.hpji.or.id

 No. Pendaftaran :

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JUDUL MAKALAH

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 Tanggal Pendaftaran:

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PENULIS MAKALAH

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1. PENYAJI PERTAMA
Nama & Gelar
Instansi
Tugas/Jabatan

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Keanggotaan HPJI
Alamat

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Anggota HPJI No:

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Bila ada Penyaji berikutnya →
2. PENYAJI KEDUA
Nama & Gelar
Instansi
Tugas/Jabatan
Keanggotaan HPJI
Alamat

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Anggota HPJI No:

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3. PENYAJI KETIGA
Nama & Gelar
Instansi
Tugas/Jabatan

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Keanggotaan HPJI

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Alamat

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Bukan Anggota

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Anggota HPJI No:
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Bukan Anggota

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CATATAN:
- Beri tanda  atau  pada bagian yang diperlukan
Kirimkan Formulir Pendaftaran berikut Abstrak & Makalah
selambat-lambatnya Jumat 10 Oktober 2014
- Mohon perhatikan Ketentuan Penulisan Abstrak & Makalah
Sebagaimana tersebut di dalam Sirkuler-1 KRTJ-13

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2014

PENDAFTAR,

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