SUBSCRIPTION
INI RADEF has Subscribing Members from all over the world.
Application Form is attached
Name:
Address:
City:
State/Province:
Country:
Email:
Annual Fee Individual Rp. 350,000 A$ 50 US$ 35
Company Rp. 700,000 A$ 100 US$ 70
Five Year Fee Individual Rp. 1,000,000 A$ 140 US$ 110
Company Rp. 2,500,000 A$ 340 US$ 260
Life enquiries to the Foundation
I/We enclose _____________________ with respect to one/5 year subscriber fee.
I/We enclose a donation to be used as follows :
Funds can be paid in cash or cheque (payable to INI RADEF) to any of our offices paid into banks in Indonesia, Australia or UK
INDONESIA
Bank Lippo, Nusa Dua,
Bali, Indonesia
Ac. No 590-30-85094-8
Ac. Name INI RADEF
Swift Code LIPBIDJA
AUSTRALIA
UNICREDIT, University of
Queensland, 4068
Ac No 16132 INI RADEF
BSB No 804-083 UK
Halifax BS, 50 High St,
Portadown N Ireland,
Ac No 2/57264925-4
Ac Name AJ & DG
WILSON for INIRADEF
Print and send this form by email to info@iniradef.com or fax to 62-361-701098