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Format 1

SIGNIFICANT ARCHITECTURAL WORK APPLICATION FOR


ASEAN ARCHITECT REGISTRATION

Receipt No.:
Name of Applicant: Muhammad Rizal Syahdan
(As written in Passport)

Title (if any): Muhammad Rizal Syahdan


(e.g. Mr., Mrs, Ms., Ar., Dr., etc)

Place and Date of Birth: Makassar, 18/02/1974


(DD/MM/YY)

Architect Registration No.: 1.1.101.2.158.29.1111880


Date of Issued: 23/12/2015
(DD/MM/YY)

Qualification: Arsitek Madya


Mailing Address: Jl. Maccini Raya no.2. Makassar. Sulawesi Selatan

Postcode: 90144
Country: Indonesia
E-mail address: rizalsyahdan@gmail.com : rizalsyahdan@yahoo.com
Cellular Phone No.: +6285242570935
Present Occupation: Architect
Office Address: Jl. Maccini Raya no.2 Makassar. Sulawesi Selatan
Postcode: 90144
Country: Indonesia
Phone/Fax No.:

I wish to be placed on the ASEAN Architect Register (AAR) and apply as described below in
accordance with the provision that defines two (2) years experience in responsible charge of
significant architectural works.

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Format 2
List of significant Architectural Work Experiences
(describe in retrospective order, beginning with the most recent one.)

Attestant's Column
Starting Date/
Work Name of Organisations/ Relationship of
Ending Date/ Name of Work Signature Tel/Fax
No. Position/Title Attestant to Applicant
(months)

1 October 2003 Rocky And Partners Build Shop / House Mursyiduddin +6285241522344
January Consultan. CV Hammado. ST
2004

January 2004
2 May 2004 Cikarsa konselindo Renovation school SD Ir. Hariwibisono. +6282191280211
Consultan. CV

August 2005
3 December Panrita Sembilan. PT Identification Open space and Park PT. Panrita Sembilan +62411421919
2007 in Makassar +6281354607210

February 2010 Universitas Muhammadiyah Dean Of


4 - Juni 2012 Makassar Unismuh Tower, Rumah Sakit Engineering +6281342099666
Pendidikan Unismuh, Balai SIdang Faculty. University
Muktamar Muhammadiyah. Of Muhammadiyah
. Makassar
Ir. Hamzah Al Imran
MT
Note: The attestant above shall be, in principle, the representative of the organisation under which the applicant executed his architectural work.

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Format 3
Detailed Description of Significant Architectural Work
(describe, in detail, each work listed in the preceding page.)

Contents of Work
Work Position in Architectural
(describe the contents and significance of the work, the applicants role, and the degree of the applicant's
No. Work
responsibility. Using about 50 words.)

1 Project Architec Build Shop / House


Managed, coordinated and supervised the overall project undertaken covers: overseeing the
preparation of survey, working drawing, schedules of materials and tender document for the building
construction; The physical facilities and lay out design for building construction as well as analysis of
budgeting and cost estimation of all civil works

2 Team Leader/Architect Renovation school SD :


design for building construction as well as analysis of budgeting and cost estimation of all civil works ;
included : (1) Preliminary Design, Development Design and Detail Engineering Design; (2)
Specifications, Bill of Quantities and Cost Estimation;

3 Team Leader/Architect Project : Identification Open space and Park in Makassar :

Survey and identification green open space and park in Makassar, and technical aid, relate at town
planing Makassar and improving government to prepare green city and continued

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Format 3
Detailed Description of Significant Architectural Work
(describe, in detail, each work listed in the preceding page.)

Contents of Work
Work Position in Architectural
(describe the contents and significance of the work, the applicants role, and the degree of the applicant's
No. Work
responsibility. Using about 50 words.)
4 Team Leader/Architect Project : Unismuh Tower, Rumah Sakit Pendidikan Unismuh, Balai SIdang Muktamar Muhammadiyah.

Planned and lay out design for building construction, Ensuring the quality control and tight supervision
of construction

Note: Make a copy of this sheet when an extra sheet is needed.

To Indonesian Monitoring Committee on Architectural Services,


I hereby declare that the above descriptions are true to the best of my knowledge.

Signature :

Architect Applicant's name: Muhammad Rizal Syahdan

Date: December 20 2016

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DECLARATION FOR ASEAN ARCHITECT (AA) APPLICATION

I hereby declare that:

YES NO

I am an Architect

I meet the entire requirements as specified in Article 3 of the


ASEAN Mutual Recognition Arrangement (MRA)

No disciplinary action have been taken against me

I am not bankrupt

Others:

Yours Sincerely,

Name: Muhammad Rizal Syahdan

Identity Card No.: 7371031802740001

Reg. No.: 1.1.101.2.158.29.1111880

Date: December 20 2016


Note: Please tick () in the relevant box.

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