Your Email

Name

Job Title

Organization

Postal Address

City

State

Country

Work Phone

Mobile

Please indicate the type of membership you are applying for
Individuals : Students; Private Employee; Government EmployeeInstitution : Government Institution ;Non-Governmental Organizations (NGOs)Prospective Member or non Member :IAP2 Friends; Partner

[group agree-pay-Individuals]
Payment Details:

• Bank Name: Bank Mandiri

• Account Number: 102-00-0600430-0

• Account Name: PL Asosiasi Partisipasi Publik

The Membership Fee for a year
Student Rp.250.000,-Private Employees Rp.500.000,-Government Employees Rp.500.000,-
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[group agree-pay-Institution]
Payment Details:

• Bank Name: Bank Mandiri

• Account Number: 102-00-0600430-0

• Account Name: PL Asosiasi Partisipasi Publik

The Membership Fee for a year
Organization/Government (max. 4 members): Rp. 1.500.000,-Organization/Government (max. 8 members): Rp. 3.000.000,-Organization/Government (max. 12 members): Rp. 4.500.000,-Organization/Government (max. 16 members): Rp. 6.000.000,-
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[group agree-pay-Prospective]
I am applying for Prospective Members or Non-Members membership
IAP2 FriendsPartners
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Please indicate which sector you work in
Government SectorPrivate SectorConsultantNon-Governmental Organizations (NGOs)Self-employedYang lain
[group other-sector-work]
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I would be happy for my information to be placed on a member only directory
YesNo

Would you like to receive email updates from IAP2 Indonesia on training, events and careers?
YesNo

[group group-bukti-pembayaran]Upload bukti pembayaran

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I agree to uphold the purpose of IAP2 Indonesia and will not do anything to bring the Association into disrepute. I hereby consent to become a member of the Association and be bound by its constitution.

I understand that by submitting this membership application I consent to receive communication sent by or on behalf of IAP2 Indonesia through my mailing address, email address, telephone and fax numbers.

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