Registration Number:K3037f
Full Name :
Place/ Date of Birth :
Sex : Male Female
Marital status: Married Single
Country :
Media Name :
Media Official Address:
Mobile Number:
Facebook Account:
Twitter Account:
Instagram Account:
Passport Number:

Has agreed to register as participant of Field Trip Program to Raja Ampat, West Papua with the requirements:

  • The opportunity only for 50 participants who already do registration in April 6-17th, 2017.
  • The participant already fill the online Registration Form or email to
  • Flight tickets purchases collectively by the committee.
  • The committee has right to choose the list of participants according to the rules.
  • For further information, please Email :

  • Terms of Participants:
    • The participant covers return tickets Jakarta - Sorong for him/herself
    • Hotel accommodation will be covered by the committee.
    • Local Transportation will be covered by the committee.
    • Follow all schedules made by committee for Saturday - Wednesday.
    • Report all field trip activities and publish it through each participants media.
    • Prepared personalized medicine.
    • Prepared personalized equipment.
    • Follow the rules of activities orderly.

    Rundown of activities:
    • May 6th, 2017, Saturday on early morning : Flight Jakarta - Sorong.
    • May 6th, 2017, Saturday night : Welcome Dinner.
    • May 7th, 2017, Sunday : Field Trip./li>
    • May 8th, 2017, Monday : Field Trip.
    • May 9th, 2017, Tuesday : Attending Anniversary Celebration of Raja Ampat District.
    • May 10th, 2017, Wednesday Morning : Flight Sorong - Jakarta.