1. Full Name
:
Email
:
Organization
:
Job Title
:
Address
:
Phone/Fax
:
Training Fee : Rp. 400.000,- (include Lunch, Snack, Accreditation Certificate by Persatuan Perawat
Nasional Indonesia (PPNI)).
Training registration fee could be paid via bank transfer to account: BNI – 0107467282 (Februadi
Bastian) or submitted directly to GDLN office.
Please fill out the form, and send back (with evidence of payment) to our office or by email before
12 March 2013
Office :
GDLN Hasanuddin University
Gedung PKP Lt. 3 Kampus Unhas Tamalanrea Km. 10
Email : gdln@unhas.ac.id
Contact Person :
Nurhaya Nurdin (081247514382) | Email : nurhayanurdin@yahoo.com
Februadi Bastian (0811467342) | Email : februadi@unhas.ac.id