CONFIRMATION OF ATTENDANCE

INTERNATIONAL CONFERENCE ON EDUCATIONAL SCIENCE AND TRAINING :

Empowering Educational Human Resources for Global Competitiveness

Please complete this form and put a tick () as appropriate as possible
Title ( ) Prof. ( ) Dr. ( ) Mr. ( ) Miss ( ) Mrs. ( ) Other ................................
Full Name (for the Certificate) ......................................
Title of the paper ......................................
Institution (Address) ......................................
Nationality ......................................
Phone number ......................................
Email ......................................
Participation as ( ) First Presenter ( ) Co-presenter ( ) Participant
Participation Fee ( ) IDR 2.000.000 (Indonesian presenter)
( ) IDR 500.000 (Indonesian Participant)
( ) USD 250 (International presenter)
( ) USD 50 (International Participant)
Payment Method Bank Transfer Proof of Payment
() Bank BNI account: Date of transfer:
c/o ICES FKIP BUNG HATTA Attached here (jpeg/pdf format):
No. Rek.: 0654478201
Bank Code: BNINIDJAPDG
009.0654478201

IMPORTANT:
Please send your presentation materials in PowerPoint format (.pptx) to
icestfkip@bunghatta.ac.id.

Once you’ve finished completing this form, please email it before July 13th
2018, At 24.00 PM.to icestfkip@bunghatta.ac.id.

Thank you.

Sincerely,

Full name and title