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FORMULIR LANGGANAN/SUBSCRIPTION

FORM
Nama/Name : _________________________________

No. kontak/contact number :


_________________________________

Email/ Email : ________________________________

Alamat/ Address :
_________________________________

Kota/City : _________________________________

Provinsi /Province :
_________________________________

Kode pos/postal code :


_________________________________

DANUM One Year 2017!


o INDIVIDUAL :
Palangkaraya area : Rp.250,000 or $25

Outside Palangkaraya : Rp.320,000 or $32

*One copy for four editions

*Including postage

o COMPANY/ORGANIZATION :
Rp. 1,000,000 or $100

Four copies for four editions


Including postage and one merchandise
Payment : Bank Negara Indonesia (BNI) 1148848819 a.n Yayasan Ranu Welum

Contact person : +62 852 4836 3553 a.n Roro I Email :


danummagazine@ranuwelum.org

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