REGISTRATION

AFSUMB Workshop & 6th Jakarta WFUMB-COE

29 – 30 November 2019

ISUM MEMBERBefore 21 October 2019
After 21 October 2019
On Site
Doctor in- training/Specialist IDR 2.500.000IDR 2.750.000IDR 3.000.000
Student/GP/SonographerIDR 2.250.000IDR 2.500.000IDR 2.750.000
NON ISUM MEMBERBefore 21 October 2019
After 21 October 2019
On Site
Doctor in- training/Specialist IDR 2.750.000IDR 3.000.000IDR 3.250.000
Student/GP/SonographerIDR 2.500.000IDR 2.750.000IDR 3.000.000
OverseasUSD 300USD 350USD 400

The registration fee include only 1 hand’s on session per day, so please choose 1 hand’s on session per day because the place is limited.

REGISTRATION FORM

NOTES

ON SITE REGISTRATION
Those who have not registered in advance may register at on-site registration desk.
Only cash payment will be accepted during on site registration.
No refund will be made for on-site registration fees.

CANCELLATION
For registration and hotel reservation cancellation
– Any cancellations must be proposed in written document: faxed or electronically mailed
– There will be 50% charges for written cancellation received before one month of the seminar.
– No refund for cancellation received before two weeks of the seminar.
– All refund will be processed after the seminar.

BANK DETAILS (RUPIAH)

Please transfer in FULL AMOUNT to account:

Bank Name: BCA – Cabang Panglima Polim Jakarta
Account Name: Dr. Irina Kurniadi
Account Number: 566 062 2456
Bank Address: Jl. Panglima Polim Raya No.16, Jakarta 12160

BANK DETAILS (US DOLLAR)

Please transfer in FULL AMOUNT to account:

Bank Name: BNI Cabang UI Depok
Account Name: Medical Ultrasound Training Centre
Account Number: 0209403390
Swift Code: BNINIDJA
Bank Address: Jl. Salemba Raya 4, Jakarta 10430, Indonesia

PAYMENT NOTES

  • Bank charges will be the responsibility of the participant
  • Upon receipt of your registration forms and the appropriate fees, an official receipt and registration confirmation will be sent to you.
  • Please show the registration confirmation at the registration desk to obtain your registration badge and congress kits.

For confirmation please sent your transfer slip to fax number: (62-21) 7230061
or email to: isum@centrin.net.id / intium@cbn.net.id

NOVOTEL MANGGA DUA SQUARE

Jl. Gunung Sahari Raya No. 1, Jakarta 14420, Indonesia

ROOM TYPEIndonesian (single/double)
Net/Room/Night
Overseas (single/double)
Net/Room/Night
Deluxe RoomIDR 800.000,-US$ 75,-

HOTEL RESERVATION

  • This field is for validation purposes and should be left unchanged.

NOTES

HOTEL RESERVATION
Hotel assignment will be made on a “FIRST COME FIRST SERVE BASIS” – If a certain hotel have been booked out, the OC has the right to allocate in another hotel with a similar standard. Applications for hotel reservation form through the secretariat.

No reservation will be made without the requested deposit. One-night deposit is required and should be paid before 30 September 2019.

ROOM RATES
All rates are indicated in rupiah per night and per room included breakfast.
Reservations must be through the secretariat to guarantee the indicated rates negotiated for the seminar.

© Copyright - AFSUMB 2019 JAKARTA - Indonesia.