Global Indonesia 2022

INDONESIA GLOBAL MUSIC CHAMPIONSHIP

Note : Kindly provide the application only once (one time submission input). Once you have submitted your application, you will receive an automated email confirmation. DO check your email during this time, as well as spam folder, as we will contact you via email if there are errors with your application.
Registration Number : (Please keep the registration number as to be used to download e-certificate and comment sheet)*
Participant's Name :*
Full Name (First, Middle, Last)
Email :*
example@example.com
Phone Number :*

Area CodePhone Number
Shipping Address :*

Street Address

City

State/ProvinceCountry

Postal / Zip Code
Date of Birth :*

DayMonthYear
Birth Certificate/Passport :*

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Teacher's Name :*
Full Name (First, Middle, Last)
Phone Number :*

Area CodePhone Number

Please set the date 1st April 2023 and your age will be displayed automatically*
Usia hari*
Age*
Select Your Category*
Repertoire/Work's Title :*
Youtube Link :*
Register more than 1 categories ? (max 3 categories)*

YesNo

Please set the date 1st April 2023 and your age will be displayed automatically*
Usia hari*
Age*
Select Your Category*
Repertoire/Work's Title :*
Youtube Link :*
Register more than 1 categories ? (max 3 categories)*

YesNo

Please set the date 1st April 2023 and your age will be displayed automatically*
Usia hari*
Age*
Select Your Category*
Repertoire/Work's Title :*
Youtube Link :*

TOTAL FEE ENCLOSED

CATEGORIESPlease select your categories

$45.00 Class

CATEGORIES 2Please select your categories

$35.00 Class

CATEGORIES 3Please select your categories

$35.00 Class

SHIPPING FEE

$35.00 Area

Enter coupon

Total

$0.00

Entry Fees are payable through :

Bank transfer to Bank Central Asia
Account number : 0881384760
Account holder : Grace Dianita Oentoro
Proof of Payment :*

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By submitting the application form, participants agree and willing to comply with all information and general rules made by the committee.*

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INDONESIA GLOBAL MUSIC CHAMPIONSHIP

TOTAL FEE ENCLOSED