Request form

Esri Student License Software Request

at Institutions with a Campus-Wide Site License

Esri Indonesia offers ArcGIS for Desktop Student 1-year software and its extensions for use by
students, lecturers, researchers, and other academia at colleges and universities that are a part of
an Esri Educational site license and under Esri Indonesia education program MoU with Esri
Indonesia.

ArcGIS for Desktop version requested:

(If you do not know the version, please ask a universitys administrator)

Contact information

Customer number :
(Filled in by Esri Indonesia)

Prefix : Ms.
Name : Oktarina Maulidia
(First name) (Last name)

Student number / NIP : 1620011013

Job title : Mahasiswa Pascasarjana

Organization :-

Department : Universitas Lampung

Address : Jalan Zainal Abidin P.A. Gg. Harapan No 4 Labuhan Ratu

City : Bandar Lampung

Province : Lampung

ZIP Code : 35142

Phone : 082280559030 Ext: 081379642558

Email : oktarinamaulidia91@gmail.com

(Preferred institutional email)

 Request form

What is/will be your primary use of GIS?

Yes, I will be your primary use of a GIS

What GIS classes are you teaching (for lecturers) / taking (for students) this year?

Yes, this year

Please describe some ways in which you use Esri GIS software to teach your students (for
lecturers):

If you would like to provide more information about how your school is using GIS, please do
so here:

If you are having question regarding this form, please send any questions or comments to
rmhitoyo@esriindonesia.co.id

Esri Indonesia values your privacy.