APPLICATION FORM

ASEAN Coal Awards

ASEAN Energy Awards 2023

Category: Best Practices

□ Special Submission

Title of Activity / Project / Theme:

Applicant General Information

Name of Company :
Business Address :
Number of Employees :
Age of Project :
Nature of Business :

Contact Person
Name :
Position :
Telephone :
Mobile phone :
Fax :
E-mail :

Project Abstract:
Not more than 200 words

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 APPLICATION FORM
ASEAN Coal Awards
ASEAN Energy Awards 2023

CERTIFICATION AND ENDORSEMENT

The (insert name of project) hereby agreed to allow the ASEAN Board of Judges and other
experts that may be designated by ACE to visit the project site and verify the authenticity of
the data. However, two weeks advance notice is required to allow for necessary
arrangements.

We also hereby agree that ACE can publish the whole submission in ACE publications and
website, without any prior consent of the owner of the project. If the submission will be
published in other publications, the consent of the concerned project owner would be
required.

We, the undersigned certified that the information given is true and accurate and prepared
with the consent of the party/ies involved.

_______________________
Name of the Applicant
Office, Position
Tel, fax, e-mail
_______________________
Name of Top Manager / Owner
Office
Position
Tel,
Fax,
E-mail

_______________________
Endorsed by Focal Point
Dr. Ing. Tri Winarno, S.T., M.T
Director of Mineral and Coal Program Development
Directorate General of Mineral and Coal
MINISTRY OF ENERGY AND MINERAL RESOURCES OF INDONESIA
Phone: +6221 8307514 Fax: +6221 83785101
Email: tri.winarno@esdm.go.id

________
For further inquiries, please contact:

ASEAN Centre for Energy

6th Floor, Jl. HR Rasuna Said, Blok X-2
Kav. 07-08 Kuningan, Jakarta 12950, Indonesia
Tel.: (6221 – 527-9332) Fax: (6221 – 527-9350)
E-mail: septia@aseanenergy.org

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APPLICATION FORM
ASEAN Coal Awards
ASEAN Energy Awards 2023

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APPLICATION FORM
ASEAN Coal Awards
ASEAN Energy Awards 2023

EXECUTIVE SUMMARY
(MAX. 1 PAGE)

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APPLICATION FORM
ASEAN Coal Awards
ASEAN Energy Awards 2023

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APPLICATION FORM
ASEAN Coal Awards
ASEAN Energy Awards 2023

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APPLICATION FORM
ASEAN Coal Awards
ASEAN Energy Awards 2023

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APPLICATION FORM
ASEAN Coal Awards
ASEAN Energy Awards 2023

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APPLICATION FORM
ASEAN Coal Awards
ASEAN Energy Awards 2023

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ASEAN Coal Awards
ASEAN Energy Awards 2023

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ASEAN Coal Awards
ASEAN Energy Awards 2023

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