Formulir Registrasi untuk Diskusi Panel 12 Agustus 2017

FORMULIR REGISTRASI
IMPLEMENTASI EFESIENSI

LOGISTIK

DALAM PAKET KEBIJAKAN EKONOMI XV

Universitas Prasetiya Mulya | Jl. R..A. Kartini (T.B. Simatupang) Cilandak, Jakarta Selatan
SABTU, 1 APRIL 2017 PK. 08.30-15.00

DATA PERUSAHAAN
Nama

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Perusahaan/Instansi
Alamat
Perusahaan/Instansi

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Kode Pos : .....................
No. Telp.

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PESERTA 1
Nama
Jabatan/Departe
men No. HP
Alamat E-mail

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PESERTA 2
Nama
Jabatan/Departe
men No. HP
Alamat E-mail

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PESERTA 3
Nama
Jabatan/Departe
men

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: .................................................... /...........................................
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No. HP
Alamat Email

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Registrasi s.d Kamis, 3
Agustus 2017