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               Please read the payment instructions below carefully before responding.

Bank Information:
Please complete this Registration Form,
or email this form to
or fax to (021) 5790 4246
Registration will be confirmed upon receipt of registration form and contribution to cost.

Payment should be made to
ICC Indonesia
USD Account No. 902.123.652
Permata Bank, Menara Kadin Branch, Jl. HR. Rasuna Said X-5 Kav. 2-3 Jakarta