Jl. Ciledug Raya No.35 blok 2A (disamping Giant Kreo)Tangerang 15154Telp. (021) 7341495, 83655577

1. NAMA/name

2.TEMPAT/TGL LAHIR /place and date of birth

3. JENIS KELAMIN/gender

4.ALAMAT/address

5. KONTAK/contact

RUMAH/KANTOR /home or office contact

TELP.GENGGAM/handphone

E-MAIL/email address

6.PENDIDIKAN TERAKHIR /last education

7. FAKULTAS/Faculty

8.NAMA SEKOLAH/UNIVERSITAS /name of your school or university

9.PILIHAN HARI KURSUS /choice of the day for the course

10. DARI MANAKAH ANDA MENGETAHUI KAMI/where do you know us

FORMULIR PENDAFTARAN

TAX-IS KNOWLEDGE CENTERPUSAT PENGEMBANGAN PRAKTISI KEAHLIAN PERPAJAKAN

(_______________________)

Pendaftar /registrant ,

Brosur/brochure Koran/newspaper

Spanduk/banner Internet/internet

Rekomendasi/Lainnya/recommendation