Online Registration

Please fill in the following form as much as possible.
You must be at least 15 years old in order to be able to register.

Note: * = Required

* Program you are interested in:

* Registration Classification:

Personal Information

Name should be same as your passport, NOT ABBREVIATED and WITHOUT EDUCATIONAL DEGREE.
* Full Name:
* Birth Place:
* Birth Date:
* Sex:
* Religion:
* Citizenship:
Passport Address:
Phone (with regional code):
* HP (Whatsapp):
Passport No.:
NISN:
* Occupation:
Company Name:
Position:
Blood Type:
Residence in Jakarta:
* Child to:	* from siblings
* Marital Status:
Fill in your e-mail below, then click Send Verification Code so that the verification code is sent to your e-mail. Next, open your e-mail and enter the verification code that has been sent in the Verification Code field below. Be sure to check your SPAM folder if the e-mail has not been received.
* E-mail:	Send Verification Code
Verification Code:
Home number, RT/RW, post code and region should be typed in the appropriate fields (do not include it in the Address field).
* Address:
RT/RW:	/
No:
Propinsi:
Kab./Kota:
Kecamatan:
Kel./Desa:
Post Code:

School Information

Special for Credit Transfer (Regular and Executive)

Family Information

Father's and mother's name should be typed WITHOUT TITLE and NOT ABBREVIATED.
* Father's Name:
Father Circumstance:
Father's Birth Place:
Father's Birth Date:
Father's ID Card No.:
Father's Education:
Father's Job:
Father's Income:
* Mother's Name:
Mother Circumstance:
Mother's Birth Place:
Mother's Birth Date:
Mother's ID Card No.:
Mother's Education:
Mother's Job:
Mother's Income:
Phone (with regional code):
Parent HP:
Parent E-mail:
Tanggungan Orang Tua:	persons
Home number, RT/RW, post code and region should be typed in the appropriate fields (do not include it in the Address field).
* Parent Address:
RT/RW:	/
No:
Propinsi:
Kab./Kota:
Kecamatan:
Kel./Desa:
Post Code:

Others