THE 39TH IVU WORLD VEGETARIAN CONGRESS 2010
“SAVE OUR LIFE, SAVE OUR PLANET”
Jakarta, October 1st - 6th, 2010 & Bali (Optional), October 7th - 9th, 2010
PASSPORT DATA
  Name

First
Middle
Last
Sex
  Passport No.
  Issuing country
  Issuing Date
  Expire Date
  Date of Birth
  Nationality
CONTACT DETAILS
  Postal Address
  Phone No.
  Mobile Phone No.
  Fax No.
  Email Address
     
  I would like to participate the three days Tour & Seminar to Bali Island
     
PAYMENT SHOULD BE MADE TO :
  Beneficiary : Indonesia Vegetarian Society
  Bank Name : Bank Central Asia KCU Asemka
  Bank Address : Jl. Asemka 27 - 30
      Jakarta Barat, 11110
  Account No. : 0013 090 081
  SWIFT CODE : C E N A I D J A