Registration Form

2018 Rotary District 3410 Conference

Grand Mercure Maha Cipta Kemayoran Hotel
Kemayoran, Jakarta, Indonesia
Friday & Saturday, 4 - 5 May 2018

Description

Please complete the form clearly, so we can record and process your registration accordingly. Mohon lengkapi pendaftaran ini agar kami catat dan proses dengan sebaik-baiknya. Plan your arrival in Jakarta, so you will not miss any part of this great event. Atur perjalanan anda agar tidak terlambat mengikuti acara yang istimewa ini.


D3410 District Conference Program :

Friday, May 4, 2018

07:30 Registration
08:30 Opening - Welcome - Keynote Speeches
10:10 Coffee Break
10:30 Plenary Session 2
11:45 Prayers & Lunch
13:15 Plenary Session 3
14:00 Break Out Session & Plenary Report
18:30 Gala Dinner

Saturday, May 5, 2018

07:30 Registration
08:30 Plenary 4 & Guest Speaking
12:00 Lunch Break
13:00 Plenary 5
18:30 Governor's Ball

Sunday, 6 May 2018

A free morning for all participants. Acara bebas untuk semua peserta
Detailed program subject to change with notices in our website www.RotaryD3410.org
Jadwal terperinci, masih dapat disempurnakan, lihat website www.RotaryD3410.org
Untuk pertanyaan dan informasi, email ke d3410discon2018@realta.co.id
Contact Person : Dyah Kusumaningrum (0857 7694 9750) or Frida (0821 1319 8101)

REGISTRANT DETAILS

*Mandatory


to be paid by bank transfer or credit card

Note : Select this for prepaid registration only!!!

You need to send the receive of the early bird payment to:

  • +6221 293 03 741 (by fax) or
  • d3410discon2018@realta.co.id (by email) or
  • Dyah K. - 0857 7694 9750 (by WA) or
  • Frida - 0813 8332 8421 (by WA)
  • I have paid Early Bird during DISCON 2017

    One person only

    Two person including spouse


    3410 other


    (you can change)

    + (country code)
    (city code)
    (you can change)
    (you can change)


    Yes No

    Yes No

    Type of Registration
    Participant and for the spouse are at the same amount

    Amount until 30 April 2018
    IDR 1,750,000.00
    including welcoming dinner & governor banquet
    Amount after 30 April 2018
    IDR 2,000,000.00
    including welcoming dinner & governor banquet

    Yes No

    Accomodation at Grand Mercure Maha Cipta Jakarta Kemayoran Hotel (select one)
    Room rate IDR 1.000.000 (nett) per room/day, including breakfast for 2 persons


    Twin Beds

    Double Bed

    Smoking

    Non Smoking

    (dd/mm/yyyy)
    (dd/mm/yyyy)

    to be paid by bank transfer or credit card

    Notes :


    Payment

    By Credit Card (Doku)? Yes Yes No


    or Transfer to:

    Bank : Bank Mandiri
    Account Name : Yayasan Rotary Indonesia Bersatu
    Account Number : 101-00-07164468

    Send proof of
    payment

    :
  • +6221 293 03 741 (by fax)
  • d3410discon2018@realta.co.id (by email)
  • Dyah K. - 0857 7694 9750 (by WA)
  • Frida - 0813 8332 8421 (by WA)
  • Rotary International District 3410 Indonesia

    Gandaria 8 Office Tower, 9th floor suite i Jl. Sultan Iskandar Muda, Jakarta 12240
    phone. +6221 29303740, fax. +6221 29303741