FORMULIR PENDAFTARAN

Billing Information
Company :
Address :
Contact Person :
Phone/Fax :
Email :
Course Title :
Course Date :

No Parcitipant Name Sertification Name Course Fees

TOTAL Rp -

Signature and Company Stamp:

Please transfer the payment to:

YAYASAN PENDIDIKAN TELKOM/TELKOMPCC
BANK MANDIRI
Account 131.00.10827.915
Name :
Date :

CANCELLATION POLICY & PAYMENT TERMS :

1. Total amount of registration include tax
2. Cancellations received within 3 working days before course commencement will not be refund.

Telephone : 022 - 2007891 / 022 - 2005180 Fax : 022 - 2007852

Email : marketing@telkompcc.co.id
Jl. Gegerkalong Hilir No.47 Bandung