Formulir registrasi Registration form

Nama perusahan Company name :

Alamat Address :

Kota City : Kode pos

Post code :

Negara Country : Kode area

Region code :

Telepon Telephone : No. fax

Fax number :

Nomor handphone Phone number : Website

Website :

Nomor kontak utama Primary contact number : E-mail

E-mail :

Nama kontak Contact name :

NPWP VAT registration no. :

Profil perusahaan Company profile1

Segmentasi bisnis Business segment2

Hospitality: Hotel, Kost, dst ... Hospitality: Hotel, Dormitory, etc ...

Hospitality: Restoran, Kafe, dst ... Hospitality: Restaurant, Cafe, etc ...

Silakan pilih (boleh lebih dari satu)Please Choose (can be more than one)

Layanan Services

Perumahan - pengembang Residential - Developer

Pabrik Manufacturing

Edukasi Education

Ritel Retail

Kantor Office

Lainnya, sebutkan: Others, specify:

Informasi tambahan: Additional comments:

Nomor Number : IBID

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Kontak 1 Contact 1

Departemen Department : Tugas

Designation :

Nama Name :

Alamat Address :

Kota City : Kode pos

Post code :

Negara Country : Kode area

Region code :

Telepon Telephone :

Ext. Ext.

No. fax Fax number :

Nomor handphone Mobile phone number : E-mail

E-mail :

Profil kontak Contact person3

Kontak 2 Contact 2

Departemen Department : Tugas

Designation :

Nama Name :

Alamat Address :

Kota City : Kode pos

Post code :

Negara Country : Kode area

Region code :

Telepon Telephone :

Ext. Ext.

No. fax Fax number :

Nomor handphone Mobile phone number : E-mail

E-mail :