TWS CERTIFIED CONSULTANT Application Form

Formulir Registrasi KONSULTAN TWS

BERSERTIFIKAT
Applicant Full Name ADE NURHASANAH AMIR
as per KTP/NRIC
Nama Lengkap Pemohon sesuai
dengan KTP/NRIC
Applicant KTP/NRIC No. 1304081406890001
Nomor KTP Pemohon
Applicant Nationality INDONESIA
Kewarganegaraan Pemohon
Applicant Nu Skin ID
ID Nu Skin Pemohon
Applicant Joined Date
Tanggal Bergabung Pelamar
Applicant RCP Display Name F9-COE ADHEK PDG
Nama Tampilan RCP Pemohon
Applicant Email Address Adheknurhasanaha@gmail.com
Alamat Email Pemohon
Applicant Contact no. 085274832282
Nomor Kontak Pemohon
Applicant Delivery Address PerumahanJabal Rahmah Residence Blok C No 2 Kubu Dalam Parak
Alamat Pengiriman Pemohon Karakah
Certification Fee
RP500,000 / USD33 / SGD50
Biaya Sertifikasi

IMPORTANT NOTE (CATATAN PENTING)

 Please transfer certification fee payment to (Silahkan transfer biaya sertifikasi ke)

INDONESIA RUPIAH (RP)

Account name: PT TWS Global System
Bank Name: CIMB Niaga
Account no: 800163415700

US DOLLAR (USD) / SINGAPORE DOLLAR (SGD)

Account name: TWS Global System Pte Ltd
Bank Name: Oversea-Chinese Banking Corporation Limited (OCBC Bank Singapore)
Bank Address: 65 Chulia Street #01-00 OCBC Centre, Singapore 049513
Account no: 601622137001
SWIFT code: OCBCSGSG

 Your application form must be submitted together with

Formulir aplikasi Anda harus diserahkan bersama dengan
o Softcopy Photo of Certification fee Payment Proof (Softcopy Foto Bukti Pembayaran Biaya
Sertifikasi)
o Softcopy Photo of KTP/NRIC (Softcopy Foto KTP/NRIC)
o Softcopy Passport size photo (Softcopy foto ukuran Passport)

Applicant Signature (Tanda tangan Pemohon)

AdeNurhasana
h Amir
(Nama): Date
(Tanggal):