Lembaga Pendidikan dan Perkebunan Jl. Jend Urip Sumoharjo No.

100, yogyakarta Phone : 0274 586201 Fax : 0274 520082

To : Muhammad Hamdi From Name : __________________________________________ Phone & Fax : __________________________________________ Company : __________________________________________

Registration Form Return On Training Investment

2 Days Program : July (12, 13) Kampus LPP - Yogyakarta

Investment Regular Rp. 3,500,000 Participant Data No Name 1. 2. 3. TOTAL INVESTMENT

Position

Email

Handphone

:Rp ____________________________________

Contact Person (for receipt) Name : _____________________________________________________________ Position : _____________________________________________________________ Address : _____________________________________________________________ Phone & Fax : ________________ ext: ________ Fax: ____________________________ Email : _____________________________________________________________ Approved by ___________________________ (Please fill in the name, signature and company stamp) CANCELLATION/RESCHEDULING POLICY Due to the considerable administration and pre-course materials associated with this program, terms of cancellations are as follows: 10 days prior to the program, Cancellation fee will be charged 30% from total Investment No show on the program, Cancellation fee will be charged 100 % from total investment

POSTPONE POLICY

If participant(s) would like to postpone the program to the next schedule, it is only allowed if the participant(s) send a prior notice 10 days before the program. PAYMENT: Full payment should be transferred before the program to: LPP Bank Mandiri Cabang UGM - Account No. : 137.00.0717342.6 Please fax the proof of payment to: 0274 520082 (att : Muhammad Hamdi) The return of this form indicates your acceptance of the above terms and condition, as well as the payment method Upon payment this registration form becomes an invoice for program enrollment. HCM for Plantation reserves the right to cancel and postpone the course due to unforeseen circumstances.