Registration Form

Term and Condition

Please complete this form and sent to Bureau 1. BV Indonesia reserves the right to change or cancel the event
Veritas Indonesia due to unforeseen circumstances
2. Event fee includes lunch, break snack, Seminar kit and
Company : __________________________________________________ certificate

Course Title : __________________________________________________
Date : __________________________________________________
Address : __________________________________________________
__________________________________________________
__________________________________________________
3. A full registration fee will be charged full for any confirmed
registration. If the registered participant is unable to attend, a
substitute is allowed with prior notification
4. Full payment should be made 1 week before course date.
5. Non Refundable Fee
6. Confirmation will send to the participant 3 days prior to event

Phone / Fax : __________________________________________________ date

7. Payment Method:
Email : __________________________________________________
Transfer to our account PT. Bureau Veritas Indonesia, PT
Name : 1. ________________________________________________
BANK MANDIRI (PERSERO) TBK
2. ________________________________________________ Menara Palma Jl. HR. Rasuna Said Blok X2 Kav.6 Jakarta
3. ________________________________________________ 12950 A/C 124 00 056 3577 7

4. ________________________________________________
WAYS TO REGISTER
Call Karina Putriarini on 021- 294 03 222
NAME : _______________ ext.605 / 0811 847 0440

POSITION : _______________ Fax : +62 21 521 0806

DATE : _______________ SIGNATURE : ______________ Email:

karina.putriarini@id.bureauveritas.com