FORM NUMBER BALI CULINARY PROFESSIONALS & MEMBER REGISTRATION FORM @ oe © @bali_culinary_protessionals bepsecretariat@gmail.com ee ee T Bali Culinary Professionals + www.baliculinaryprotesional.com f Registration Category : PROFESSIONAL NEW MEMBER Oo RENEWAL Oo Fee 1.000.000,- IDR per year Fee 600.000,- IDR per year PLEASE WRITE IN CAPITAL LETTERS, Title First Name Date of Birth Family Name Phone Number Email Address Company Address Company Phone Number Company Website Sign By Uniform Size : XL xx. O a xxx O] rzo | Apply for membership and declare the above informations given is correct, im aware and agreed, membership applications only efective upon approved by Board of YCCI Comittee and BCP Commite as mother organizations. Board of BCP Committee The undersigned, Board of committee Bali Culinary Professionals confirms that above candidate fulfils the conditions, for one year active membership period, January - December 2024