Total Building 10th Floor

Jl. Letjen. S. Parman Kav. 106A - Jakarta 11440

Telp. (021) 56972919, 56972920
Fax. (021) 56972921
cs@binainsan.co.id;
binainsan.konsulindo@yahoo.com
www.binainsan.co.id

REGISTRATION FORM CFA LEVEL 1 PREPARATION TRAINING

Periode :
...........................................
NAME

BIRTH DATE
__

Date

/ __

Month

/ __

SEX
Male
Year

Fimale

OFFICE NAME & ADDRESS

POSITION

OFFICE PHONE
NO

EMAIL OFFICE

HANDPHONE NO

FAX NO

HOME ADDRESS

PERSONAL EMAIL

HOME PHONE
NO

FORMAL EDUCATION

MAJOR

GRADUATION
YEAR

Jakarta, _______ / _______ / ______

For payment, please wait

confirmation
from Binainsan

Signature & Full Nama

Please sent the complete form via email to : cs@binainsan.co.id or via fax : (021)
56972921

 Forms can be copied if the candidates more than 1 (one) person.