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REGISTRATION FORM

Please fill in the form on the right to complete your registration.

Registration Fee

Domestic (Indonesia)

Early Bird: Rp 8.000.000

Regular: Rp 8.500.000

Overseas

Early Bird: USD 850.00

Regular: USD 900.00

Registration Benefits

June 11, 2026 - Gala Dinner & Networking Night
June 12, 2026 - Conference
June 13, 2026 - Networking Golf or City Tour

Seminar Benefits

30 SKP from AAMAI
30 points CPD from LSP AAUI
30 SKP from APARI
10 points PSB from LSP PS
15 points PDU from LSP GRK
Qualification Level 6 & 7 from LSPPI
30 points CPD from LSP AKASI
10 points PSB from Islamic Insurance Society
36 points PSB from LSP MK

Informasi Umum General Information

Sapaan* Salutation

Nama Lengkap* Full Name

Jabatan* Job Title

Perusahaan* Company

Alamat Email* Email Address

Nomor Telepon* Phone Number
Gunakan nomor yang terhubung dengan WhatsApp Use a number connected to WhatsApp

Name to appear on conference Badge *

WhatsApp or Line *

Other email (alternative receiver) *

Association

Company Address *

City *

Postal Code *

Country *

Hotel

Risk Management Certification

Visa on Arrival

Business Line

Insurer

Insured

Rating Agency

Auditor

Insurance Broker

Reinsurer

Consultant

Actuary

Reinsurance Broker

Regulator

Other

Vegetarian

I would like to have vegetarian meals during the Conference.

** All meals served at the Conference will be prepared without pork and lard.

Outdoor Activity *

Arrival Time

Departure flight time end of event (12 June 2026)

Agreement *

I agree that the personal data I provide may be used and published by the committee, at its sole discretion, for the purposes of the event.

Unggah Berkas File Upload

Unggah Foto Diri* Upload Self Photo*

Klik untuk unggah Foto Diri

Click to upload Self Photo

Format: JPG, JPEG, PNG. Max. 2MB

Info: This photo will be used for identification purposes and will appear during the on-site check-in process.

Peserta Tambahan Additional Participants

Isi Nama, Email, dan Nomor Telepon untuk peserta tambahan. Company dan informasi lainnya akan mengikuti data di atas.

Pertanyaan Tambahan Additional Questions

Bermalam* Overnight Stay

YA YES

TIDAK NO

Membawa Bagasi* Bring Luggage

TIDAK

Kode voucher / Coupon code