INA
–
Van Oord Golf Tournament 2015
Riverside Golf & Country Club, 23
rdOctober 2015
YES, I will participate in the INA
–
Van Oord Golf Tournament 2015, on Friday 23
October 2015 at the Riverside Golf & Country Club.
(Please fill in as applicable)
Full Name
:
Name : ________________________________
Title :________________________________
Company : ________________________________
Handicap : ________________________________
Size of T-shirt :________________________________
Phone : ________________________________
Email : ________________________________
Name : ________________________________
Title :________________________________
Company : ________________________________
Handicap : ________________________________
Size of T-shirt :________________________________
Phone : ________________________________
Payment can be made in cash at the Tournament or settled in advance by transfer to:
PT BANK RABOBANK INTERNATIONAL INDONESIA
Jl. Plaza 89, Jl H. R Rasuna Said Kav. X-7 No. 6 Jakarta 12940 Indonesia. Indonesian Netherlands Association. Swift Code: RABOIDJA. Bank account number: 06.00.001371 (EUR); 06.00.001369 (IDR)
OR
BANK MANDIRI – KCP JKT GATOT SUBROTO Jl, Ged. Menara Jamsostek Lt.1 Menara Utara, Indonesia Indonesian Netherlands Association. Swift code: BMRIIDJA
Account No.: 070-00-0656490-5 (IDR)
(Please fax the registration and copy of your payment to (+62-21)5290-2178 or Scanned email to:
