CONFIRMATION of ATTENDANCE LETTER (CAL)

INTERNATIONAL CONFERENCE ON EDUCATION AND TRAINING:

Quality Improvement in Education and Training: Theory and Practices

Please complete this form and put a tick () as appropriate as possible
Title ( ) Prof. ( ) Dr. ( ) Mr. ( ) Miss ( ) Mrs. ( ) Other
Full Name (for the Certificate)
Title of the paper
Institution (Address)
Nationality
Phone number
Email
Participation as ( ) First Presenter ( ) Co-presenter ( ) Participant
Participation Fee ( ) USD 100 (International presenter; with soft copy proceedings)
( ) IDR 500.000 (local presenter ; with soft copy proceedings)
( ) IDR 350.000 (participant / co-presenter; without soft copy
proceedings)
( ) IDR 400.000 (participant; with soft copy proceedings)
Payment Method Bank Transfer Proof of Payment
( ) BCA Bank account: Date of transfer:
c/o Dwi Nur Nikmah Attached here (jpeg/pdf format):
No. Rek.: 0110433549
Bank Code: 014….
Participation Involvement ( ) Pre Conference Tour (free of charge)
( ) Main conference :( ) Panel Conference
:( ) Parallel Conference
:( ) Business Meeting
( ) Post Conference Tour (need for another confirmation, call the
committee contact person as in the website) – additional charge
Accommodation Method ( ) By myself / independently (recomended)
( ) By committee assist (need for another confirmation, call the
committee contact person as in the website)

IMPORTANT:
Once you’ve finished completing this form, please email it before November
15th 2016, At 24.00 PM.to icet@fipum.com Thank you.
Sincerely,

Full name and title