Full Name
Ms.
Mr.
Dr.
Prof.
Hon.
Prefix
First Name
Last Name
Institution name
Institution type
Please Select
Academic/research
Government
Civil society/non-profit
Private sector
Independent/Other
Primary discipline
Please Select
Social Sciences
Humanities
Ecology/Environmental Sciences
Engineering, Architecture & Design
Law & Socio-legal Studies
Urban and Regional Planning
Activism & Pedagogy
Other
Phone Number
*
-
Area Code
Phone Number
E-mail
*
Presence
On-Site Presentation
Online
If you are participating in person, we´d be delighted to host you throughout this three-day conference. However, we do understand that you´d be compelled to attend only select dates. Please indicate your anticipated participation on all three / select dates:
11th September,2023
12th September,2023
13th September, 2023
Title of talk/presentation
*
Language of presentation/talk (where possible, we´d be organising simultaneous interpretation):
English
Indonesian
Javanese
Participation at pre-event evening guided tour (Kampung Memory Walk), followed by an open-airhomecooked coastal kampung dinner on the 10th of September (approx. 100,000 IDR or 6.00 EUR per person fordinner)
Yes/ Interested
No
Attendance at the conference dinner at aselected restaurant in central Jakarta on the 12th of September, 7pm (cost approx. 250,000 IDR or 16.00 EUR per person)
Yes
No
If yes, please indicate dietary preferences, if relevant:
Please Select
Vegetarian
Vegan
Nut-based allergies or sensitivity
None of the above
Submit
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