*) The Following students are qualified to participate in the conference. College students, graduate
school students, vocational school students. The students will be requested to attach the copy of
certificate of studentship issued by their school to the appliication form.

COST INCLUDING THE REGISTRATION FEE
- Dentist, physician, dental technician, hygienist Conference participation fee, conference proceeding,
certificate of Attendance, fee of coffee breaks, lunch at conference hall on May 2,3, and 4
- Students, Conference participation fee, conference proceeding, Certificate of Attendance.

Method to file the Registration
1. Online registration (under construction)
2. Write the necessary information in the Registration Form attached to booklet and send it to the
 Secretariat AiB by mail or fax,

One application form must be submitted per one applicant. If there are plural number of applicants,
copy the applicant form or request the additional form to the Secretariat. After confirming the receipt
of fee, we will send the receipt and participation acknowledgement certificate by fax and email, sms.
You will be requested to present the participation acknowledgement certificate at the conference at the
conference site, so please do not forget to bring it with you.

                  We as you to pay the registration fee by the following method.

                                      RUPIAH Payment transfer to  
                                                      Account Name      : Rudi Wigianto
                                                     Account Number   : 7730 2222 75
                                                         BANK CENTRAL ASIA (BCA)
                                                   Cabang Hasanudin , Denpasar, Bali

                                     US Dollar Payment transfer to
                                                  Account Name        : Robert H Dharma
                                                  Account Number    : 0904381225
                                                                 PERMATA BANK,
                                                          Menteng Branch, Jakarta

*fax all completed form and copy of payment transfer slip to : (62) 0361 261278

The registration form must arrive the Secretariat on and before 31st December, 2007. Please note that
the forms received on and after 1 st January 2008 are treated as the application submitted on the day
of conference.

"Cancellation of application"
Please notify the Secretariat when to cancel the early registration. Please note that the cancellation will
be treated by the following rule.
Cancellation before 31st December 2007 50% of fee already paid will be refunded
Cancellation on and after 1st January 2008 no refund is made
Above refund will be remitted after the completion of conference.
Participant
 EARLY REGISTRATION
 REGULAR REGISTRATION
  before 31st Dec 2007
  
Dentist, Doctor, Scientist
 US $ 225 / Rp. 2.000.000
 US $ 250 / Rp.2.275.000
Dental Hygienist  
 US $ 200 / Rp. 1.850.000
 US $ 225 / Rp 2.000.000
Dental Technician
 US $ 200 / Rp. 1.850.000
 US $ 225 / Rp 2.000.000
*) Student
 US $ 125 / Rp. 1.137.500
 US $ 150 / Rp 1.500.000
Download here for registration form (jpeg file)