participant form IFRS 2013 Final
IFRS Seminar 2013
Monday, 26 August2013,InterContinental Jakarta MidPlaza Hotel,
Jl. Jend.SudirmanKav 10-11, Jakarta, Indonesia
Seminar Registration Form
Contact Person: Ibu Nancy Saskiawati, Sekretariat PAI
Tel: (62) 21 8355105 or mobile phone 0816917477,Email to:[email protected]
Personal Particulars
No
Name (Mr./ Mrs./ Ms./ Dr/ Prof)
Title
Membership *)
Seminar Fee
1.
Rp.
2.
Rp.
3.
Rp.
4.
Rp.
5.
Rp.
Total Fee
Rp.
Note:
*) Please write membership status: PAI and Registration Number or SOA or non-member
Contact Person: _________________________________________________________________________________
Company Name: _________________________________________________________________________________
Company address:________________________________________________________________________________
________________________________________________________________________________________________
Tel:
(
)__________________________Mobile: (
)___________________________________________
Fax
(
)___________________________ Email: __________________________________________________
Early Bird (until 2 Aug 2013)
Normal Price(until 19 Aug 2013)
□ PAI/ SOAmember: Rp 1,750,000 *)
□
PAI/ SOA member: Rp 2,000,000 *)
□ Non-Member:
□
Non-Member:
Rp. 2.000.000
Rp. 2.250.000
Full registration fees MUST be paid before the valid dates for admittance at seminar.
Only registrations FULLY PAID FOR by the early-bird deadline will be eligible for the discount.
*) PAI members who have paid annual PAI membership fee.
Payment:
Transfer to the following account:
Bank MandiricabangTebet Raya
PersatuanAktuaris Indonesia (PAI),Rekening number:124-00-0519311-6
Please send the registration form, transfer receipt of seminar fee and PAI membership fee to Ibu Nancy at
[email protected]
Monday, 26 August2013,InterContinental Jakarta MidPlaza Hotel,
Jl. Jend.SudirmanKav 10-11, Jakarta, Indonesia
Seminar Registration Form
Contact Person: Ibu Nancy Saskiawati, Sekretariat PAI
Tel: (62) 21 8355105 or mobile phone 0816917477,Email to:[email protected]
Personal Particulars
No
Name (Mr./ Mrs./ Ms./ Dr/ Prof)
Title
Membership *)
Seminar Fee
1.
Rp.
2.
Rp.
3.
Rp.
4.
Rp.
5.
Rp.
Total Fee
Rp.
Note:
*) Please write membership status: PAI and Registration Number or SOA or non-member
Contact Person: _________________________________________________________________________________
Company Name: _________________________________________________________________________________
Company address:________________________________________________________________________________
________________________________________________________________________________________________
Tel:
(
)__________________________Mobile: (
)___________________________________________
Fax
(
)___________________________ Email: __________________________________________________
Early Bird (until 2 Aug 2013)
Normal Price(until 19 Aug 2013)
□ PAI/ SOAmember: Rp 1,750,000 *)
□
PAI/ SOA member: Rp 2,000,000 *)
□ Non-Member:
□
Non-Member:
Rp. 2.000.000
Rp. 2.250.000
Full registration fees MUST be paid before the valid dates for admittance at seminar.
Only registrations FULLY PAID FOR by the early-bird deadline will be eligible for the discount.
*) PAI members who have paid annual PAI membership fee.
Payment:
Transfer to the following account:
Bank MandiricabangTebet Raya
PersatuanAktuaris Indonesia (PAI),Rekening number:124-00-0519311-6
Please send the registration form, transfer receipt of seminar fee and PAI membership fee to Ibu Nancy at
[email protected]