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A

Application & Contract Form


12 - 16 June 2024
Indonesia Convention Exhibition (ICE) - BSD City, Indonesia

Please fill with CAPITAL LETTER and return the original form to the organiser *

We, the undersigned :


Name : ............................................................................................... Phone : ..................................................................................................
Position : ........................................................................................... Mobile : .................................................................................................
Company : ......................................................................................... Fax : ......................................................................................................
Brand : .............................................................................................. Email : ...................................................................................................
Address : ........................................................................................... Website : ...............................................................................................
........................................................................................................... Business Line : ......................................................................................
........................................................................................................... Category of Product : .............................................................................
City : .................................................................................................. ..............................................................................................................
Country : ............................................................................................ Tax Registration No. : .............................................................................
Post Code : ......................................................................................... ..............................................................................................................

BOOTH NO. SPACE (SQM) PRICE RATE TOTAL PRICE (IDR)

- COMPLIMENTARY

Jakarta ...........................................................

Signature & Company Stamp

Filled By The Organiser

Account Executive Event Manager Finance Approval Received Date

PT. Debindo Global Expo


Jl. KH. Abdullah Syafei No. 9 Jakarta 12840, Indonesia
Phone : (62-21) 83797405 | Fax. : (62-21) 83797412
Email : debindo.globex@gmail.com

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