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Form Registrasi

Administrator

·

Oct 17, 2023

·

Bitmap Batam Form

First name:(Required)

First Last

Email(Required)

Enter Email Confirm Email

Phone Number(Required)

Title / Jabatan :

Are You Willing toJoin?(Required)

Yes

No

Other

Address :(Required)

Type Of Business (Yearly Membership) :(Required)

Hotel (Rp.3.800.000)

Refleksi (Rp.1.800.000)

Massage/ Spa (Rp.2.800.000)

Clubs/ KTV (Rp.3.800.000)

Shops/ Toko (Rp.1.000.000)

Restaurant (Rp.1.800.000)

Coffeshop (Rp.1.300.000)

UMKM (Rp.700.000)

Join Date(Required)

MM slash DD slash YYYY

Download File Perjanjian Iklan dibawah ini, isi lalu upload kembali di formulir registrasi

Perjanjian Iklan(Required)

Max. file size: 900 MB.

Pembayaran hanya melalui No rek bank BCA 3400571111
Atas nama PT APLIKASI TERPADU ANDALAN

Administrator

Bitmap Batam

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