Application for Enrollment

Company Sponsored Development Program

Date of Request 30 September 2019

Applicant Name* Gusti Ayu Ketut Vitha Adinda NID 2160807
Position Consultant
Department* HROT
Division HROT
Program Title TECHTalk: MIT
Brief descriptions of the program content:

TECHTalk: "MIT Sustainable Initiative – co-creating a sustainable and inclusive tech and eco-community in
Southeast Asia.
Organized by Tsea Asia
Organizer e-mail -
Organizer Phone - Fax
Course Venue
City Bali Country Indonesia
Course start date 1 Oktober 2019 End date 1 Oktober 2019
Course Cost Note
Method of Payment Cash / Bank Transfer:
Cost Center Department Division
Traveling Required / not required Allowance
Travel Insurance Required / not required (please use the appropriate form)
Transportation Flight / train / car / other:-
Departure date - pref. time
Return date - pref. time
Hotel Accomm. Required / not required
Check-in date - check-out date
Visa Required / not required
Fiscal Tax Required / not required
Airport Tax Required / not required
Cash advance Required / not required (please use the appropriate form)
Other requirements -
Preferred sharing session date -
Preferred audience for sharing Management / Consultant / Non-consultant / All
How is the program related to your job responsibilities? (please describe in approx. 300 words)

How will it contribute to your job performance? (please describe in approx. 300 words)

please submit this application to People Department at least 5 days in advance for domestic held program, or 2 weeks
for program held abroad. also attach a copy of brochure or printed program description.

Requested by, Acknowledge by, Approved by, Checked by,

Applicant Direct Supervisor Director People Department Finance Department

PD-DADI-DEV-F1-ENROLLMENT