[ Registration Form ]

KPPIKG

For Foreign participants

Hilton Hotel package (Registration and accommodation)
Single 2 nights + registration fee US$ 375 3 nights + registration fee US$ 450	Twin share 2 nights + registration fee US$ 300/person 3 nights + registration fee US$ 375/person

For Local Participants

Before March 1, 2006 Rp. 800.000,-

March 1 - July 31, 2006 Rp. 1.000.000,-

After Aug 1, 2006 Rp. 1.200.000,-

Local student/ technicians/ dental nurse

Cancellation

Participants are welcome to visit the exhibition without any charges

Payment by cash or transfer

In Rupiah
Beneficiary name: Dr. Siti Aliyah P., SpPM
Bank: BNI 46 UI Depok/Salemba Branch, Jakarta
Account number: 000534.9354

Dollarplus
Beneficiary name : drg. Siti Aliyah P, Sp.PM
Bank : BNI 46 UI Depok/Salemba Branch, Jakarta
Acc no. : 936 39 899
(please fax the receipt to the secretariat)

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