Scribd Logo
Upload

Welcome to Scribd!

  • Registration Form - Date - Name

    Uploaded by

    Nadya Irsalina
    8 views2 pages
    This document is a registration form for a conference. It requests information such as the participant's name, affiliation, contact details, paper title if presenting, and whether they will attend on-site or via webinar. It outlines the different conference package options including the proceedings, and lists the local and international prices for regular, student and participant rates.

    Original Description:

    Original Title

    20200620_REGISTRATION FORM_DATE_NAME

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    This document is a registration form for a conference. It requests information such as the participant's name, affiliation, contact details, paper title if presenting, and whether they will attend on-site or via webinar. It outlines the different conference package options including the proceedings, and lists the local and international prices for regular, student and participant rates.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    8 views2 pages

    Registration Form - Date - Name

    Uploaded by

    Nadya Irsalina
    This document is a registration form for a conference. It requests information such as the participant's name, affiliation, contact details, paper title if presenting, and whether they will attend on-site or via webinar. It outlines the different conference package options including the proceedings, and lists the local and international prices for regular, student and participant rates.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 2

    DATE:

    REGISTRATION FORM
    PARTICIPANT INFORMATION: Please Print Clearly/ Tick only related

    Assoc.
    Designation Professor Dr. Mr./ Ms.
    Prof

    Name:

    Affiliation:

    Mailing :
    Address

    Telephone: Fax: Email:

    PAPER TITLE (PRESENTER ONLY):

    PARTICIPANT: Tick only related

    Participant Participant
    Status: Presenter
    (On-site) (Webinar)

    CATEGORY: Tick only related

    Status Regular Student

    PRESENTATION (PRESENTER ONLY) : Tick only related

    Oral Video Presentation


    Presentation (Unable to attend On-site conference)
    PAYMENT

    Type: International Local

    CONFERENCE PACKAGE:
    C: Conference Package
    PA: Proceeding (ASSEHR proceeding series)

    Price per paper

    Package Description Local Rate (IDR) Tick Int’l Rate (USD) Tick
    only only
    Early Early
    Normal related Normal related
    Bird Bird
    Presenter
    R-PA C + PA 5.700.000 6.200.000 480 580
    (Regular)
    Presenter
    S-PA C + PA 4.700.000 5.200.000 430 530
    (Student)
    Participant
    PR On-site C 4.000.000 4.500.000 350 400
    Regular
    Participant
    PS On-site C 3.000.000 3.500.000 300 350
    Student
    Participant
    PW C - 1.000.000 - 70
    Webinar

    You might also like