formulir pendaftaran

Formulir Pendaftaran Program Edukasi
Transforma Institute
1. PROGRAM EDUKASI
Berikut ini program edukasi Transforma Institute pada Bulan April 2016:
Kode
PE1
PE2
PE3
PE4
PE5
2.
Deskripsi Program
Blueprint Program Peningkatan Kualitas Data: Perancangan Arsitektur dan Governance
Rabu-Kamis, 6-7 April 2016 @ Golden Flower Hotel Bandung, Biaya Investasi Rp. 3.960.000 (Include PPN)
TOGAF 9 Foundation
Rabu-Jumat, 13-15 April 2016 @ Grandia Hotel Bandung, Biaya Investasi Rp. 4.950.000 (Include PPN)
Penyusunan Application Architecture Berbasis BPM dan SOA
Rabu-Kamis, 20-21 April 2016 @ The Luxton Hotel Bandung, Biaya Investasi Rp. 3.960.000 (Include PPN)
Pengembangan IT Governance Berbasis COBIT 5
Rabu-Kamis, 27-28 April 2016 @ De Java Hotel Bandung, Biaya Investasi Rp. 3.960.000 (Include PPN)
CISA (Certified Information System Auditor) Review 2016
Setiap Sabtu, 16 Apr – 4 Jun 2016 @ Red Planet Hotel Bekasi , Biaya Investasi Rp. 5.830.000 (Include PPN)
Biaya Optional:
Membership ISACA, Buku Import CISA Review 2016, CDROM Database Soal-Jawab CISA, silakan kontak lebih lanjut
dgn admin jika berminat
FASILITAS HOTEL
Fasilitas hotel berikut ini bersifat optional (silakan kontak jika membutuhkan informasi hotel lainnya):
Kode
H1
H2
H3
H4
H5
Deskripsi Fasilitas
Golden Flower Hotel, Jl. Asia Afrika No. 15-17 Bandung, T. 022-4239999, Superior, Rate Rp. 635.000/malam weekdays
Grandia Hotel, Jl. Cihampelas No. 82 Bandung, T.022-42690111, Deluxe Rate Rp. 650.000/malam weekdays
The Luxton Hotel, Jl. Ir. H. Juanda No. 18 Bandung, T. 022-4220700, Deluxe, Rate Rp. 850.000/malam weekdays
De Java Hotel, Jl. Sukajadi No.148-150 Bandung, T. 022-2039888, Deluxe, Rate Rp 678.000/malam weekdays
Red Planet Hotel, Kawasan BluPlaza Kav 27-36 Jl.Chairil Anwar, T.021-29689222, Standar, Rate Rp. 450.000/malam
DATA PESERTA:
3.
No
1
2
3
4
5
BIAYA TOTAL
Nama
Jabatan
Nomor HP & Email
HP:
Email:
HP:
Email:
HP:
Email:
HP:
Email:
HP:
Email:
Pilihan Paket (Lingkari Pilihan)
PE1/PE2/PE3/PE4/PE5
H1/H2/H3/H4/H5= ….. malam
PE1/PE2/PE3/PE4/PE5
H1/H2/H3/H4/H5= ….. malam
PE1/PE2/PE3/PE4/PE5
H1/H2/H3/H4/H5= ….. malam
PE1/PE2/PE3/PE4/PE5
H1/H2/H3/H4/H5= ….. malam
PE1/PE2/PE3/PE4/PE5
H1/H2/H3/H4/H5= ….. malam
: .................................................................................................................................................................................
DATA ORGANISASI/PERUSAHAAN:
Nama
: ................................................................................................................................................................................
NPWP
: ................................................................................................................................................................................
Alamat
: ................................................................................................................................................................................
Contact Person : ……………………………………………………………..................................................................................................................
HP/Telepon
: ………………………………………..................... Fax / E-mail: ............................................................................................
Bandung, ......................................2016
Rekening:
Bank Mandiri KC Bandung Setrasari Plaza
______________________________
No. Rek. 132.0098.555.999
Tanda tangan & Nama Lengkap
a.n PT Transforma Rekayasa dan Solusi
Keterangan:
Untuk kepastian penyiapan training kit dan fasilitas lainnya, mohon formulir terisi & bukti transfer dapat dikirim sebelum batas akhir
pendaftaran (H-3) (ke nomor fax: +62-22-8724-1348 atau email ke [email protected]
Pembatalan setelah batas akhir pendaftaran, dikenakan biaya administrasi 50%.