UNIVERSITY OF DIRGANTARA MARSEKAL SURYADARMA
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Campus : Jl. Halim Perdana Kusuma No.1, RT.1/RW.9, Halim Perdana Kusumah, Kec. Makasar, Kota Jakarta Timur, Daerah Khusus Ibukota Jakarta 13610
Lecture at UNSURYA Jakarta is
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Catalog/Brochure Request Form
FREE via Mail (Post)
If you need a catalog / brochure for your partner (with the same address),
it can be done by
writing a few names
,
for example : Arif Raharjo, Budi Ahmadi, Cecep Setiawan, and so on.
We will send you a catalog / brochure in accordance with the number of names written.
If you want the catalog / brochure is also sent to several friends / family
with a different address
, then please also fill in Name & Address other (names, addresses, and so on).
Recipient's name
required
Address
(Address, Houses No., RT/RW, etc.)
required
City/Province
required
Zip Code
required
Email
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Each time you fill the "name" below, then the address, city, and its POS codes are required.
Name 2
can be emptied
Address 2
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City/Province 2
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Zip Code 2
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Name 3
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Address 3
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City/Province 3
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Zip Code 3
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Name 4
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Address 4
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City/Province 4
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Zip Code 4
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Request catalog / brochure can also be done by
send your name and address
via SMS to mobile :
0817 0816 486
