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    Application - API (New Member) 2015

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    Herlambang Andy
    This document is an application form for membership in the Indonesian Geothermal Association (INAGA). It requests the applicant's contact information and company details if applicable. The form lists membership categories including student, personal, exploration company, production company, associate company, and senior citizen. Membership fees are provided for initial starting fees and annual fees for each category. The form requests the applicant select a category and payment method including bank transfer details.

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    Application - API (New Member) 2015

    Uploaded by

    Herlambang Andy
    6 views1 page
    This document is an application form for membership in the Indonesian Geothermal Association (INAGA). It requests the applicant's contact information and company details if applicable. The form lists membership categories including student, personal, exploration company, production company, associate company, and senior citizen. Membership fees are provided for initial starting fees and annual fees for each category. The form requests the applicant select a category and payment method including bank transfer details.

    Original Description:

    formulir API

    Original Title

    Application_API (New Member) 2015_ (1)

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    This document is an application form for membership in the Indonesian Geothermal Association (INAGA). It requests the applicant's contact information and company details if applicable. The form lists membership categories including student, personal, exploration company, production company, associate company, and senior citizen. Membership fees are provided for initial starting fees and annual fees for each category. The form requests the applicant select a category and payment method including bank transfer details.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    6 views1 page

    Application - API (New Member) 2015

    Uploaded by

    Herlambang Andy
    This document is an application form for membership in the Indonesian Geothermal Association (INAGA). It requests the applicant's contact information and company details if applicable. The form lists membership categories including student, personal, exploration company, production company, associate company, and senior citizen. Membership fees are provided for initial starting fees and annual fees for each category. The form requests the applicant select a category and payment method including bank transfer details.

    Copyright:

    © All Rights Reserved
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    of 1

    APLICATION FOR MEMBERSHIP

    The Indonesian Geothermal Association (INAGA)


    Assosiasi Panasbumi Indonesia (API)
    Please complete the following form and return it with payment to :
    Asosiasi Panasbumi Indonesia (API) Indonesian Geothermal Association
    (INAGA)
    Ruang Geothermal Lantai 2 Area Kolam Renang PERTAMINA SIMPRUG
    Jl. Sinabung Terusan II Simprug Jakarta Selatan.Telp: 021-36820173
    Email: api.inaga@yahoo.co.id Web: www.inaga.org
    Enroll me as a member of API/INAGA

    Last Name

    Renew my membership to API/INAGA

    First Name

    Middle Initial

    Name :
    Position :
    Company :
    Work Address :

    Phone :
    Home Address :

    Phone :
    E-Mail :
    SEND THE NEWSLETTER API TO
    Work Address

    Zip :
    Fax :

    Zip :
    Fax :

    Home Address

    MEMBERSHIP CATEGORY

    Starting Fee

    Student

    Rp. 250.000,-

    Personal

    Annual fee
    Rp. 100.000,-

    Rp. 500.000,-

    Rp. 500.000,-

    Exploration Company

    Rp. 50.000.000,-

    Rp. 10.000.000,-

    Production Company

    Rp. 50.000.000,-

    Rp. 20.000.000,-

    Ascociate Company

    Rp. 50.000.000,-

    Rp. 10.000.000,-

    Rp. 300.000,-

    Rp. 100.000,-

    Senior (>60)

    Note: Please cycle one of them.


    PAYMENT
    2016 Dues
    Contribution

    Rp.
    Rp.

    Total Enclosed
    Rp.
    All payment must be made to:

    Asosiasi Panasbumi Indonesia (API)


    A/C No. : 008-01-60697-00-6 Bank : NIAGA Cab. Gajah Mada

    Cash/Personnel Bank Checks to APIs Secretariat at anytime

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