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FORM PENDAFTARAN

PAMERAN BLU-PPP EXPO 2013 KEMENPERA

Nama Institusi/Instansi/Perusahaan

: ...............................................................................................

Alamat

: ...............................................................................................

Nomor Telepon

: ...............................................................................................

Nama Perumahan *)

: ...............................................................................................

Alamat Perumahan

: ...............................................................................................

Jumlah unit rencana realisasi 2013 *)

: ...............................................................................................

Pihak yang dapat dihubungi


Nama

: ..........................................................................................

HP

: ..........................................................................................

Email

: ..........................................................................................

............... , .......................... 2013


Penanggung jawab,

(...............................)
*)

Diisi jika pesertanya adalah pengembang


Form dapat disampaikan;
Bandung, (Deden S. Rachmat, Email/HP: densrachmat@yahoo.com/0812 2145142
Bogor, (Susan Asiani, Email/Hp: susan.asiani@yahoo.com/0812 1043394)
Semarang, (Eko, Email/Hp: puriraosbdg@gmail.com/0818 322515
Malang, (Chandra Gumelar, Email/Hp: candragumelar@roketmail.com/0815 6221546)
Makassar, (Agung, Email/Hp: agung.oembar@yahoo.com/0811 1838 763)
Banjarmasin, (Ibnu, Email/Hp: ibnu.manaf@yahoo.co.id/0813 1400 9813)
Pontianak, (Hesty, Email/Hp: hesti.latifa@gmail.com/0812 9744 650)
Medan, (Maya, Email/Hp: sigarmaya@gmail.com/0819 3273 3688)
Palembang, (Adhe, Email/Hp: oktavatko@yahoo.co.uk/0852 1915 8046)
Tangerang, (Budi, Email/Hp: budhi@proximaconvex.com/0812 1105 671)
Blu-PPP Kemenpera : blupppexpo2013@gmail.com

F1 - BANDUNG

FORM PENDAFTARAN
PAMERAN BLU-PPP EXPO 2013 KEMENPERA

Nama Institusi/Instansi/Perusahaan

: ....................................................................................................

Alamat

: ....................................................................................................

Nomor Telepon

: ....................................................................................................

Nama Perumahan *)

: ....................................................................................................

Alamat Perumahan *)

: ....................................................................................................

Jumlah unit rencana realisasi 2013 *)

: ....................................................................................................

Pihak yang dapat dihubungi


Nama

: ..........................................................................................

HP

: ..........................................................................................

Email

: ..........................................................................................

............... , .......................... 2013


Penanggung jawab,

(...............................)
*) Diisi jika pesertanya adalah pengembang
Form dapat dikirim melalui:
1. Email:
- BLU-PPP Kemenpera
2. Fax BLU-PPP Kemenpera
3. HP :
- BLU-PPP Kemenpera
- Syarif Halim
4. Hotline
- BLU-PPP Kemenpera

: blupppexpo2013@gmail.com
: 021-7220050
: 0812 240 40009
: 0812 240 40006
: 021-7225338

F2 - BOGOR

FORM PENDAFTARAN
PAMERAN BLU-PPP EXPO 2013 KEMENPERA

Nama Institusi/Instansi/Perusahaan

: ...............................................................................................

Alamat

: ...............................................................................................

Nomor Telepon

: ...............................................................................................

Nama Perumahan *)

: ...............................................................................................

Alamat Perumahan

: ...............................................................................................

Jumlah unit rencana realisasi 2013 *)

: ...............................................................................................

Pihak yang dapat dihubungi


Nama

: ..........................................................................................

HP

: ..........................................................................................

Email

: ..........................................................................................

Bogor, .......................... 2013


Penanggung jawab,

(...............................)
*) Diisi jika pesertanya adalah pengembang
Form dapat disampaikan kepada:
1. Email:
- BLU-PPP Kemenpera
2. Fax BLU-PPP Kemenpera
3. HP :
- BLU-PPP Kemenpera
- Syarif Halim
4. Hotline
- BLU-PPP Kemenpera

: blupppexpo2013@gmail.com
: 021-7220050
: 0812 240 40009
: 0812 240 40006
: 021.7225338

F3 - SEMARANG

FORM PENDAFTARAN
PAMERAN BLU-PPP EXPO 2013 KEMENPERA

Nama Institusi/Instansi/Perusahaan

: ...............................................................................................

Alamat

: ...............................................................................................

Nomor Telepon

: ...............................................................................................

Nama Perumahan *)

: ...............................................................................................

Alamat Perumahan

: ...............................................................................................

Jumlah unit rencana realisasi 2013 *)

: ...............................................................................................

Pihak yang dapat dihubungi


Nama

: ..........................................................................................

HP

: ..........................................................................................

Email

: ..........................................................................................

Semarang, .......................... 2013


Penanggung jawab,

(...............................)

*) Diisi jika pesertanya adalah pengembang


Form dapat disampaikan kepada:
1. Email:
- BLU-PPP Kemenpera
2. Fax BLU-PPP Kemenpera
3. HP :
- BLU-PPP Kemenpera
- Syarif Halim
4. Hotline
- BLU-PPP Kemenpera

: blupppexpo2013@gmail.com
: 021-7220050
: 0812 240 40009
: 0812 240 40006
: 021.7225338

F4 - MALANG

FORM PENDAFTARAN
PAMERAN BLU-PPP EXPO 2013 KEMENPERA

Nama Institusi/Instansi/Perusahaan

: ...............................................................................................

Alamat

: ...............................................................................................

Nomor Telepon

: ...............................................................................................

Nama Perumahan *)

: ...............................................................................................

Alamat Perumahan

: ...............................................................................................

Jumlah unit rencana realisasi 2013 *)

: ...............................................................................................

Pihak yang dapat dihubungi


Nama

: ..........................................................................................

HP

: ..........................................................................................

Email

: ..........................................................................................

Malang, .......................... 2013


Penanggung jawab,

(...............................)

*)

Diisi jika pesertanya adalah pengembang


Form dapat disampaikan kepada;
1. Email:
- BLU-PPP Kemenpera
2. Fax BLU-PPP Kemenpera
3. HP :
- BLU-PPP Kemenpera
- Syarif Halim
4. Hotline
- BLU-PPP Kemenpera

: blupppexpo2013@gmail.com
: 021-7220050
: 0812 240 40009
: 0812 240 40006
: 021.7225338

F5 - MAKASSAR

FORM PENDAFTARAN
PAMERAN BLU-PPP EXPO 2013 KEMENPERA

Nama Institusi/Instansi/Perusahaan

: ...............................................................................................

Alamat

: ...............................................................................................

Nomor Telepon

: ...............................................................................................

Nama Perumahan *)

: ...............................................................................................

Alamat Perumahan

: ...............................................................................................

Jumlah unit rencana realisasi 2013 *)

: ...............................................................................................

Pihak yang dapat dihubungi


Nama

: ..........................................................................................

HP

: ..........................................................................................

Email

: ..........................................................................................

Makassar, .......................... 2013


Penanggung jawab,

(...............................)

*) Diisi jika pesertanya adalah pengembang


Form dapat disampaikan kepada:
1. Email:
- BLU-PPP Kemenpera
2. Fax BLU-PPP Kemenpera
3. HP :
- BLU-PPP Kemenpera
- Agung
4. Hotline
- BLU-PPP Kemenpera

: blupppexpo2013@gmail.com
: 021-7220050
: 0812 240 40009
: 0812 240 40007
: 021-7225338

F6 - BANJARMASIN

FORM PENDAFTARAN
PAMERAN BLU-PPP EXPO 2013 KEMENPERA

Nama Institusi/Instansi/Perusahaan

: ...............................................................................................

Alamat

: ...............................................................................................

Nomor Telepon

: ...............................................................................................

Nama Perumahan *)

: ...............................................................................................

Alamat Perumahan

: ...............................................................................................

Jumlah unit rencana realisasi 2013 *)

: ...............................................................................................

Pihak yang dapat dihubungi


Nama

: ..........................................................................................

HP

: ..........................................................................................

Email

: ..........................................................................................

............... , .......................... 2013


Penanggung jawab,

(...............................)

*) Diisi jika pesertanya adalah pengembang


Form dapat disampaikan kepada:
1. Email:
- BLU-PPP Kemenpera
2. Fax BLU-PPP Kemenpera
3. HP :
- BLU-PPP Kemenpera
- Agung
4. Hotline
- BLU-PPP Kemenpera

: blupppexpo2013@gmail.com
: 021-7220050
: 0812 240 40009
: 0812 240 40007
: 021-7225338

F8 - MEDAN

FORM PENDAFTARAN
PAMERAN BLU-PPP EXPO 2013 KEMENPERA

Nama Institusi/Instansi/Perusahaan

: ...............................................................................................

Alamat

: ...............................................................................................

Nomor Telepon

: ...............................................................................................

Nama Perumahan *)

: ...............................................................................................

Alamat Perumahan

: ...............................................................................................

Jumlah unit rencana realisasi 2013 *)

: ...............................................................................................

Pihak yang dapat dihubungi


Nama

: ..........................................................................................

HP

: ..........................................................................................

Email

: ..........................................................................................

............... , .......................... 2013


Penanggung jawab,

(...............................)

*) Diisi jika pesertanya adalah pengembang


Form dapat disampaikan kepada:
1. Email:
- BLU-PPP Kemenpera
2. Fax BLU-PPP Kemenpera
3. HP :
- BLU-PPP Kemenpera
- Maya
4. Hotline
- BLU-PPP Kemenpera

: blupppexpo2013@gmail.com
: 021-7220050
: 0812 240 40009
: 0812 240 40008
: 021-7225338

F7 - PONTIANAK

FORM PENDAFTARAN
PAMERAN BLU-PPP EXPO 2013 KEMENPERA

Nama Institusi/Instansi/Perusahaan

: ...............................................................................................

Alamat

: ...............................................................................................

Nomor Telepon

: ...............................................................................................

Nama Perumahan *)

: ...............................................................................................

Alamat Perumahan

: ...............................................................................................

Jumlah unit rencana realisasi 2013 *)

: ...............................................................................................

Pihak yang dapat dihubungi


Nama

: ..........................................................................................

HP

: ..........................................................................................

Email

: ..........................................................................................

............... , .......................... 2013


Penanggung jawab,

(...............................)

*) Diisi jika pesertanya adalah pengembang


Form dapat disampaikan kepada:
1. Email:
- BLU-PPP Kemenpera
2. Fax BLU-PPP Kemenpera
3. HP :
- BLU-PPP Kemenpera
- Agung
4. Hotline
- BLU-PPP Kemenpera

: blupppexpo2013@gmail.com
: 021-7220050
: 0812 240 40009
: 0812 240 40007
: 021-7225338

F9 - PALEMBANG

FORM PENDAFTARAN
PAMERAN BLU-PPP EXPO 2013 KEMENPERA

Nama Institusi/Instansi/Perusahaan
: ...............................................................................................
Alamat

: ...............................................................................................

Nomor Telepon

: ...............................................................................................

Nama Perumahan *)

: ...............................................................................................

Alamat Perumahan

: ...............................................................................................

Jumlah unit rencana realisasi 2013


: ...............................................................................................
*)
Pihak yang dapat dihubungi
Nama : ..........................................................................................
HP

: ..........................................................................................

Email

: ..........................................................................................

............... , .......................... 2013


Penanggung jawab,

(...............................)

*) Diisi jika pesertanya adalah pengembang


Form dapat disampaikan kepada:
1. Email:
- BLU-PPP Kemenpera
: blupppexpo2013@gmail.com
2. Fax BLU-PPP Kemenpera: 021-7220050
3. HP :
- BLU-PPP Kemenpera
: 0812 240 40009
- Maya
: 0812 240 40008
4. Hotline
- BLU-PPP Kemenpera
: 021-7225338

F10 - TANGERANG

FORM PENDAFTARAN
PAMERAN BLU-PPP EXPO 2013 KEMENPERA

Nama Institusi/Instansi/Perusahaan

: ...............................................................................................

Alamat

: ...............................................................................................

Nomor Telepon

: ...............................................................................................

Nama Perumahan *)

: ...............................................................................................

Alamat Perumahan

: ...............................................................................................

Jumlah unit rencana realisasi 2013 *)

: ...............................................................................................

Pihak yang dapat dihubungi


Nama

: ..........................................................................................

HP

: ..........................................................................................

Email

: ..........................................................................................

............... , .......................... 2013


Penanggung jawab,

(...............................)

*) Diisi jika pesertanya adalah pengembang


Form dapat disampaikan kepada:
1. Email:
- BLU-PPP Kemenpera
2. Fax BLU-PPP Kemenpera
3. HP :
- BLU-PPP Kemenpera
- Maya
4. Hotline
- BLU-PPP Kemenpera

: blupppexpo2013@gmail.com
: 021-7220050
: 0812 240 40009
: 0812 240 40008
: 021-7225338