Name Competition / APSC

PAPER COMPETITION PETROLIDA 2016

Petrolida Conjunction with APSC 2016
Registration Form
University / SPE SC

: POLITEKNIK PERKAPALAN NEGERI SURABAYA (

SHIPBUILDING INSTITUTE OF POLITECHNIC SURABAYA

Email Address
Team Name*

: mail.ppns.ac.id / humas.ppns.ac.id
:-

Offshore Rig name**

:-

The Title of Your Paper*** : Dark Energy Converting the sea pressure water
through the Hybrid System to optimize offshore Oil Rig
Function
First Participant ( Team Leader)
Full Name

: Tri Agung Prasetyo

Place, Date of Birth

: Mojokerto, May 13 1995

Gender

: Male

Student ID Card No.

: 6813040046

Passport No. / ID No.

: 3516061305950003

Year Of Study / Semester : 6th Semester ( Bachelor of Applied Science)

Mobile Phone No.

: 082330944929

Email

: triagung95@gmail

T-Shirt Size

:L

Second Participant
Full Name

: Muhammad Shaleh

Place, Date of Birth

: Balikpapan, May 1 1994

Gender

: Male

Student ID Card No.

:6813040042

Passport No. / ID No.

: 3513190105940003

Year Of Study / Semester : 6th Semester ( Bachelor of Applied Science)

Mobile Phone No.

: 085230400383

Email

: slehmuh@ymail.com

T-Shirt Size

: XL

Third Participant
Full Name

: Mohammat Rohmad Fuadi

Place, Date of Birth

: Pasuruan, October 20 1994

Gender

: Male

Student ID Card No.

: 6813040035

Passport No. / ID No.

:-

Year Of Study / Semester : 6th Semester ( Bachelor of Applied Science)

Mobile Phone No.

: 085785566932

Email

: rohmatfuad@gmail.com

T-Shirt Size

:L

Description:
Please fill out the form in accordance with number of participants

*For Case Study Competition and Petrosmart Competition only

** For Oil Rig Design Competition only

*** FOR PAPER COMPETITION ONLY