Please complete the following form and return it with payment to :Asosiasi Panasbumi Indonesia (API) Indonesian Geothermal Association (INAGA)Ruang Geothermal Lantai 2 Area Kolam Renang PERTAMINA SIMPRUG Jl. Sinabung Terusan II Simprug Jakarta Selatan.Telp: 021-36820173 Email: api.inaga@yahoo.co.id Web: www.inaga.orgLast NameFirst NameMiddle InitialName :Position :Company : Work Address :Zip :Phone :Fax :Home Address :Zip :Phone :Fax :E-Mail :SEND THE NEWSLETTER API TO Work Address Home AddressMEMBERSHIP CATEGORYStarting FeeAnnual fee Student Rp. 250.000,- Rp. 100.000,- Personal Rp. 500.000,- Rp. 500.000,- Exploration Company Rp. 50.000.000,- Rp. 10.000.000,- Production Company Rp. 50.000.000,- Rp. 20.000.000,- Ascociate Company Rp. 50.000.000,- Rp. 10.000.000,- Senior (>60) Rp. 300.000,- Rp. 100.000,- Note: Please cycle one of them.PAYMENT 2016 DuesRp. ContributionRp.Total EnclosedRp.All payment must be made to:Asosiasi Panasbumi Indonesia (API) A/C No. : 008-01-60697-00-6 Bank : NIAGA Cab. Gajah MadaCash/Personnel Bank Checks to APIs Secretariat at anytime Renew my membership to API/INAGA Enroll me as a member of API/INAGAAPLICATION FOR MEMBERSHIPThe Indonesian Geothermal Association (INAGA)Assosiasi Panasbumi Indonesia (API)