Registration form for Language Courses, Indonesia

Politeknik Cristo Re

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First name

Last name

Email

Select Your Institution

Select Course

Address

Enter Complete Physcial Address

Phone

Date of Upload

Governent ID card like NRC/ Driving Licence/ Passport / Date of Birth certificate etc.

maximum file size 300kb
Acceptable file type: JPG, PNG, PDF, MSword

Student Photo

maximum file size 300kb
Acceptable file type: JPG, PNG, PDF, MSword

Last Qualification Document

maximum file size 300kb
Acceptable file type: JPG, PNG, PDF, MSword

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I affirm that all the Informtion Provided by me here is accurate. I understand that if any inaccuracies are discovered, my admission maybe cancelled or my login can be revoked, and all fees paid will be forfeited