INDONESIAN FIRE & RESCUE CHALLENGE · 2 16th INDONESIAN FIRE & RESCUE CHALLENGE 12 - 22 November...

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Transcript of INDONESIAN FIRE & RESCUE CHALLENGE · 2 16th INDONESIAN FIRE & RESCUE CHALLENGE 12 - 22 November...

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16th INDONESIAN FIRE & RESCUE CHALLENGE 12 - 22 November 2013, PT Nusa Halmera Minerals – Gosowong,

North Halmahera

This year hosted by PT Nusa Halmahera Minerals (PTNHM). Accommodation will be available with facility including daily service shuttle bus from and to the competition venue.

A unique chance to see fire and rescue teams go through their paces and learn valuable lessons from others

A great time to show your support and get your Company noticed by rescue and safety professionals from many of the largest mining, oil and gas operations in Indonesia

Two Hands represents explore and preserve – PTNHM as a responsible mining company. It also represents sustainable and long lasting business flow and good relationship between each competitive companies in the challenge. Red Flame represents the mining industry while at the same time forming a dynamic flames that represents fire, while at the same time creates a unique symbol of two opening hand gesture that shows rescue / helping. Earthly drawings of Halmahera Islands represents Halmahera and PTNHM in particularly. The Green represents Nature, while the red represents Fire and Rescue. Halmahera Marahai means Beautiful Halmahera, as well as acronym in bahasa: HApuskan Lara, bersaMA HEmpaskan deRA, MAri RAih HArapan & Impian.

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1. Keputusan Dewan Indonesia Fire &

Rescue

Dewan Indonesia Fire & Rescue menetapkan bahwa kegiatan Tahunan Fire & Rescue yang akan diselenggarakan di PT Nusa Halmahera Minerals -Gosowong, Kabupaten Halmahera Utara, Provinsi Maluku Utara menggunakan konsep Challenge.

Konsep Challenge bukan hanya berarti kompetisi, namun lebih sebagai upaya belajar dari yang lain.

Indonesian Fire & Rescue Challenge memperkenankan tim untuk menangani insiden sementara tim lain dapat mengamati dan belajar dari simulasi tersebut. Setiap tim selanjutnya diberikan skenario yang sama dengan menerapkan prosedur dan teknik yang berbeda, semuanya akan dinilai.

2. Kapan dan dimana 16th Indonesian Fire and Rescue Challenge akan diselenggarakan pada tanggal 12 November sampai dengan 22 November 2013, dipusatkan di Tobelo, Kabupaten Halmahera Utara, Provinsi Maluku Utara dengan PT. Nusa Halmahera Minerals bertindak sebagai tuan rumah.

3. Nomor yang akan dipertandingkan:

Tes Kompetensi Regu Pemadam

Kecelakaan Kendaraan dan Penyelamatan/ Manajemen Korban Massal

Penyelamatan di Ketinggian Penyelamatan di Air Pertolongan & Penyelamatan pada

bangunan runtuh Penyelamatan Korban di Ruang Terbatas Pemadaman Kebakaran pada Bangunan Firefighter Fitness Drill

1. Board of Indonesian Fire & Rescue

Decision

Indonesian Fire & Rescue Board determined that the Annual Fire & Rescue event which will be held in PT Nusa Halmahera Minerals - Gosowong, North Halmahera Regency, North Maluku Province will applying the Challenge concept.

The Challenge concept will not serve merely as a competition, but also means to learn from others.

The Indonesian Fire & Rescue Challenge allows a team to handle an incident while others observe and learn. Each team will further be provided with a similar scenario for demonstration of different techniques and procedures which will be subject to scoring.

2. When and Where

16th Indonesian Fire and Rescue Challenge will be held from 12 November to 22 November 2013 centralized at Tobelo, North Halmahera Regency, North Maluku Province and hosted PT. Nusa Halmahera Minerals.

3. Challenge Events:

Firefighter Competency Test (FCT) Motor Vehicle Accident & Mass Casualty

Response (MVA & MCR)

High Angle Rescue - Slope (HAR) Water Rescue (WTR) Collapsed Structure Search & Rescue

(CSSR)

Confined Space Rescue (CSSR) Structural Firefighting (SFF) Firefighter Fitness Drill (FFD)

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Catatan:

Skenario dan sistim penilaian akan dikirim secara terpisah.

Informasi detail mengenai Tools, Equipment, & Accessories (TEA) akan dikirimkan bersamaan dengan skenario challenge dan sistim penilaian.

4. Pendaftaran

Pendaftaran dibuka tanggal 22 April – 12 Oktober 2013

5. Akomodasi Peserta Akomodasi berupa Tenda Komando akan disediakan oleh Panitia Pelaksana 16th Indonesian Fire & Rescue Challenge di Bumi Perkemahan yang terletak di Pusat Kota Tobelo, lengkap dengan sarana Mandi & Toilet. Masing-masing Tim yang telah dinyatakan resmi ikut challenge akan mendapatkan jatah 1 Tenda Komando yang bisa mengakomodir 10 personil dan TEA Tim. Makan ringan pagi, makan siang, makan ringan sore dan akomodasi selama challenge di site (Tobelo) akan ditanggung oleh Panitia Penyelenggara. Catatan: - Bagi tim yang mengirimkan lebih dari 10

personil dapat menyewa hotel di dekat lokasi bumi perkemahan challenge (lihat daftar hotel di Tobelo)

- Tim Peninjau disediakan makan siang tanpa fasilitas akomodasi.

- Tenda komando bagi setiap tim akan ditentukan dengan cara diundi pada Pertemuan Teknis nanti.

- Pengaturan laundry akan dibahas saat technical meeting

Notes:

Scenario and scoring system will be sent separately.

Tools, Equipment, & Accessories (TEA) detailed information will be sent along with challenge scenario and scoring system.

4. Registration Registration is set to open from 22 April to 12 October 2013

5. Participant Accommodation

The 16th Indonesian Fire & Rescue Challenge Committee will provide commando tents for accommodation in the campsite which is located in the center of Tobelo city, equipped with shower and toilet facilities. For those who have been officially declared to join the challenge entitled for 1 commando tent which accommodates 10 personnel and TEA Team. Morning light meals, lunch, afternoon snack and accommodation will be provided by Organizing Committee for every participants during the challenge (Tobelo). Note: - For those with more than 10 team-

members have an option to rent room(s) at the nearby hotels (See the attached List of Hotels in Tobelo)

- Compliment Lunch for the Observer Team exclude accommodation facility.

- Commando tents will be drawn at Technical Meeting

- Laundry arrangement will be discussed in the Technical meeting

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6. Transportasi Sebagai bahan informasi dan untuk memudahkan pengaturan transportasi, maka beberapa hal di bawah ini perlu mendapat perhatian: a. Bandar Udara yang terdekat adalah

Bandara Sultan Babullah, Ternate. b. Tim dapat menggunakan sejumlah

Maskapai Penerbangan seperti: Lihat informasi mengenai transportasi udara

c. Transportasi - Peserta akan dijemput oleh Panitia

Penyelenggara di Bandar Udara Sultan Babullah, Ternate dan selanjutnya diantar ke Hotel yang telah di dipesan setiap tim.

- Setiap tim wajib memberi informasi tanggal kedatangan, keberangkatan, maskapai penerbangan dan nomor penerbangan kepada Panitia Pelaksana.

- Pada hari mobilisasi, peserta akan berkumpul di Hotel Bela, Ternate menuju pelabuhan Masjid Raya.

- Ternate menuju Pelabuhan Sidangoli di Halmahera akan ditempuh dengan menggunakan speed boat.

- Pelabuhan Sidangoli menuju Tobelo akan menggunakan kendaraan kecil.

- Perincian rencana mobilisasi peserta akan dibahas lebih lanjut pada Pertemuan Teknis.

- Panitia hanya menanggung biaya transportasi mobil kecil untuk peserta dalam rangka keperluan mobilisasi antar kabupaten dan lokasi challenge (Sidangoli, Tobelo, Tomabaru, Gosowong).

6. Transportation

For your valuable information and in organizing transportation the following should be taken into account:

a. The closest airport is Sultan Babullah

Airport, Ternate. b. Participating Teams can use a number of

airlines such as: Refer to air transportation information

c. Transportation - Participants will be picked up by

Organizing Committee at Sultan Babullah Airport in Ternate to be further dropped at the booked hotel for teams.

- Each team shall inform the arrival and departure date along with airlines and flight number to Organizing Committee.

- On mobilization day, participants shall

gather at Bela Hotel, Ternate to go to Masjid Raya Port.

- Mobilization from Ternate to Sidangoli Port at Halmahera Island will use speed boat as transportation.

- Sidangoli Port to Tobelo will use light vehicles.

- Details plan for participants mobilization will be discussed further at Technical Meeting.

- Organizing Committe will cover participant’s light vehicle transportation cost only for inter-regency and mobilization to challenge locations purposes (Sidangoli, Tobelo, Tomabaru, Gosowong).

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7. Hotel di Ternate & Tobelo Lihat daftar/informasi hotel di Ternate dan Tobelo.

8. Persyaratan Medis Setiap anggota rescue tim harus memiliki surat keterangan dokter yang menyatakan anggota tersebut dalam keadaan sehat fisik maupun mental dan dapat melakukan kegiatan fire rescue dan penyelamatan dalam jangka waktu tertentu serta kondisi di bawah tekanan.

Pejabat yang diangkat/ditunjuk dari tim Anda harus hadir pada saat registrasi untuk menandatangani dan memverifikasi bahwa semua anggota tim peserta telah menerima pemeriksaan fisik yang diminta selama satu tahun sebelum tanggal kontes dan dinyatakan sehat secara fisik, terlatih dan mampu mengikuti challenge sesuai regulasi.

9. Pertemuan Teknis

Instruktur dan Manajer diundang untuk menghadiri Pertemuan Teknis yang akan dilaksanakan di Tobelo, Ibukota Halmahera Utara pada tanggal 18 – 22 September 2013. Kegiatan akan diadakan di Poli Gran Convention Hall.

Board dan panitia lokal akan memberikan presentasi tentang kesiapan panitia lokal, skenario lomba, sistim penilaian, hal lain sehubungan dengan lomba.

Pertemuan Teknis akan dirangkaikan dengan Collapsed Structure Search & Rescue Workshop – Menembus dinding beton & Door Shoring serta Deliver Clinical Care Training dari Safety Plus Training Pty Ltd. Pelatihan tersebut di atas merupakan wajib bagi Tim yang akan mengikuti Challenge.

7. Hotels in Ternate & Tobelo Refer to hotel list/information in Ternate and Tobelo.

8. Medical Requirement Each member of the rescue team shall have a doctor’s certificate stating that he/she is in a fit physical and mental condition and is able to perform fire rescue and recovery work within a specific period of time under strenuous conditions. The designated official in charge of your team shall be present during registration to sign and verify that all participating team members have undergone the required physical examination for one year prior to the contest date and are physically fit, trained and qualified to enter the challenge as per regulation

9. Technical Meeting

Instructors and Managers are invited to attend a Technical Meeting which will be held in Tobelo, City of North Halmahera from 18 to 22 September 2013. The venue is Poli Gran Convention Hall.

Board and Local Committee will provide a presentation on the local committee preparedness, competition scenario, scoring system and other competition- related matters.

Technical meeting will be combined with Collapsed Structure Search & Rescue Workshop – Breaking through Concrete Wall, & Door Shoring and Deliver Clinical Care Training from Safety Plus Training Pty Ltd. The training is mandatory for the participating teams in the Challenge.

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TRANSPORTATION

Airlines Route Flight # ETD - ETA [LT]

MAKASSAR - TERNATE

UPG-TTE GA-660 05:30 - 08:30

TERNATE - MAKASSAR

TTE-UPG GA-661 12:15 - 13:05

MANADO - TERNATE

MDC - TTE GA-684 09:35 - 11:35

TERNATE - MANADO

TTE - MDC GA-685 09:10 - 08:55

JAKARTA -MAKASSAR -

TERNATE

CGK - UPG UPG - TTE

GA-640 GA-660

00:30 - 04:00 05:30 - 08:30

TERNATE - MAKASSAR -

JAKARTA

TTE-UPG-CGK GA-661 GA-605

12:15 - 13:05 14:00 - 15:20

TTE-UPG-CGK

GA-661 GA-643

12:15 - 13:05 16:05 - 17:25

TTE-UPG-CGK

GA-661 GA-655

12:15 - 13:05 17:30 - 18:50

TTE-UPG-CGK

GA-661 GA-603

12:15 - 13:05 17:45 - 19:05

TTE-UPG-CGK

GA-661 GA-609

12:15 - 13:05 18:00 - 19:20

JAKARTA - MANADO - TERNATE

CGK - MDC *) MDC-TTE

GA-602 GA-684

08:25 - 14:20 *) 09:35 - 11:35

CGK - MDC *)

MDC-TTE GA-600 GA-684

10:55 - 15:15 *) 09:35 - 11:35

CGK - MDC *)

MDC-TTE GA-606 GA-684

18:10 - 22:30 *) 09:35 - 11:35

*) Overnight at Manado (1 night)

TERNATE - MANADO - JAKARTA

TTE-MDC MDC-CGK

GA-685 GA-601

09:10 - 08:55 16:05 - 18:10

TTE-MDC MDC-CGK

GA-685 GA-603

09:10 - 08:55 15:05 - 18:50

BALIKPAPAN - MAKASSAR -

TERNATE BPN-CGK-UPG *)

UPG-TTE

GA-561/GA-602

GA-660

06:25-07:30 /08:25-11:44 *)

05:30 - 08:30

BPN-CGK-UPG *)

UPG-TTE

GA-561/GA-608

GA-660

06:25-07:30 /09:40 - 13:10 *)

05:30 - 08:30

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BPN-CGK-UPG *)

UPG-TTE

GA-563/GA-616

GA-660

09:20 - 10:25 /13:00 - 16:30 *)

05:30 - 08:30

BPN-CGK-UPG *)

UPG-TTE

GA-563/GA-616

GA-660

09:20 - 10:25 /13:00 - 16:30 *)

05:30 - 08:30

BPN-CGK-UPG *)

UPG-TTE

GA-565/GA-610

GA-660

10:50 - 11:55/ 14:00-17:30 *)

05:30 - 08:30

BPN-CGK-UPG *)

UPG-TTE

GA-565/GA-616

GA-660

10:50 - 11:55/ 13:00 - 16:30 *)

05:30 - 08:30

BPN-CGK-UPG *)

UPG-TTE

GA-567/GA-612

GA-660

13:00 - 14:05/ 17:15 - 20:40 *)

05:30 - 08:30

BPN-UPG *)

UPG-TTE GA-663 GA-660

19:55 - 21:05 *) 05:30 - 08:30

BPN-CGK-UPG

UPG-TTE

GA-571/GA-652

GA-660

17:35 - 18:40/ 20:30 - 01:45 +1

05:30 - 08:30

BPN-CGK-UPG

UPG-TTE

GA-571/GA-650

GA-660

17:35 - 18:40/ 21:00 - 00:30 +1

05:30 - 08:30

BPN-CGK-UPG

UPG-TTE

GA-573/GA-652

GA-660

18:30 - 19:35/ 20:20 - 01:45 +1

05:30 - 08:30

BPN-CGK-UPG

UPG-TTE

GA-575/GA-640

GA-660

19:25 - 20:30/ 00:30 - 04:00 +1

05:30 - 08:30

*) Overnight at Makassar (1 night)

+1 Penerbangan tiba pada hari berikutnya

TERNATE - MAKASSAR - BALIKPAPAN

TTE-UPG UPG-CGK-BPN

GA-661 GA-605/GA-

574

12:15 - 13:05 14:00 - 15:20/17:25 - 20:35

TTE-UPG

UPG-CGK-BPN

GA-661 GA-655/GA-

576

12:15 - 13:05 17:30 - 18:50 /19:50 -

23:00

SURABAYA - MAKASSAR-

TERNATE

SUB-UPG UPG-TTE

GA-631 GA-660

05:25 - 07:55 *) 05:30 - 08:30

SUB-UPG UPG-TTE

GA-667 GA-660

20:05 - 22:35 *) 05:30 - 08:30

*) Overnight at Makassar (1 night)

TERNATE - MAKASSAR -

TTE-UPG UPG-SUB

GA-661 GA-630

12:15 - 13:05 19:35 - 20:05

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TERNATE TTE-UPG

GA-661 GA-666

12:15 - 13:05 *) 06:20 - 06:50

*) Overnight at Makassar (1 night)

MANADO - TERNATE MDC-TTE SJ-691 12:00 - 13:45

TERNATE - MANADO TTE-MDC SJ-690 08:00 - 07:45

JAKARTA - TERNATE CGK-TTE

SJ-598 00:30 - 07:20

SJ-776 05:00 - 10:40

TERNATE - JAKARTA TTE-CGK

SJ-777 11:20 - 13:00

SJ-599 14:45 - 17:45

SURABAYA - TERNATE

SUB-MDC-TTE SJ-268/SJ-

691 07:50 - 11:25/ 12:00 - 13:45

SUB-UPG-TTE

SJ-570/SJ-598

21:35-00:05 +1 / 04:30-07:20

SJ-562/SJ-598

23:05-01:35 +1 / 04:30-07:20

+1 Penerbangan tiba pada hari berikutnya

TERNATE - SURABAYA

TTE-MDC-SUB SJ-690/SJ-

269 08:00-07:45 / 08:30-10:05

TTE-UPG-SUB SJ-599/SJ-

567 14:45-15:40 / 16:30-17:00

BALIKPAPAN - TERNATE

BPN-UPG UPG-TTE

SJ-174 SJ-598

15:00 - 16:05 *) 04:30 - 07:20

*) Overnight at Makassar (1 night)

BPN-CGK CGK-TTE

SJ-159 SJ-598

17:40 - 18:40 *) 04:30 - 07:20

*) Overnight at Makassar (1 night)

TERNATE -

BALIKPAPAN TTE-MDC-SUB-BPN

SJ-690/SJ-269/

SJ-252

08:00 - 07:45 / 08:30 - 10:05/

11:10 - 13:40

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JAKARTA - TERNATE CGK-TTE JT-776 05:00 - 11:45

TERNATE - JAKARTA TTE-CGK JT-777 13:40 - 19:00

MANADO - TERNATE MDC-TTE JT-1170 09:55 - 11:45

TERNATE - MANADO TTE-MDC JT-1175 13:50 - 13:40

SURABAYA - TERNATE

SUB-CGK-TTE JT-583 JT-776

21:50 - 23:20 *) 05:00 - 11:45

*) Overnight at Jakarta (1 night)

TERNATE - SURABAYA

TTE-MDC MDC-SUB

JT-1175 JT-737

13:50 - 13:40 17:15 - 18:50

*) Wings-Air

JAKARTA - TERNATE CGK-TTE XN-820 02:00 - 07:50

TERNATE - JAKARTA TTE-CGK XN-821 14:00 - 14:00

MAKASSAR - TERNATE UPG-TTE XN-826 10:20 - 13:15

TERNATE - MAKASSAR TTE-UPG XN-827 08:45 - 08:45

SURABAYA - TERNATE

SUB-UPG-TTE XN-826 07:20 - 13:15

TERNATE - SURABAYA TTE-UPG-SUB XN-827 08:45 - 08:45

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LIST OF HOTELS IN TERNATE

No Hotel Name Star

Rating Address Phone # Type

Number of Room

Room Rate

Single Twin Published

Corporate (IDR)

1 BELA

INTERNATIONAL HOTEL

4 stars

Jl. Raya Jati No. 500 Ternate

59346, Indonesia

0921-3123800 0921-3121800

Deluxe 129 1000000 710000

Cabanas 12 1300000 980000

Executive Deluxe 32 1600000 1080000

Executive Jr. Suite 8 2500000 2150000

Executive Suite 2 3500000 3355000

Kie Raha Suite 2 2800000 2935000

Poolside Cottage 1 Bed

3 2500000 1600000

Poolside Cottage 2 Beds

3 3100000 2110000

2 HOTEL SAFRINA

TRANSITO TBA

Jl. Anggrek Dacomib, No 09

Ternate 0921-3121222

Deluxe 10 340000

Twin 19 360000

Sweet Room 3 - 500000

3 CORNER PALACE

HOTEL TBA

Jl. Stadion - Ternate

0921-3111295, 081356132026

Executive Suite 8 470000/550000

Business Deluxe 10 17 320000/340000

Superior 6 300000

President Suite 1 1750000

4 ARCHIE HOTEL Melati

Jl. Nuku No.100. Kel Muhajirin,

Ternate

0921-3121197, 3110555

Single Standard - 5 275000 -

Single Superior 6 295000 -

King Size 4 295000

Twin Superior 4 325000

Twin Standar 2 300000

Deluxe King 1 365000

5 NERACA

GOLDEN HOTEL Melati

Jl. Pahlawan Revolusi, No.30

0921-3121668

Standar 11 150000 -

Deluxe 17 200000 -

VIP 7 250000 -

Superior A 5 300000 -

Superior B 6 350000 -

6 BOULEVEARD

HOTEL Melati

Jl. Jatiland No. 1-5 ,Ternate

0921-3121197, 0921-3110555

Standar 40 9 302500 -

Business 4 363000 -

Business Twin 10 4 375100 -

Deluxe 5 453750 -

7 EMERALD HOTEL Melati Jl. Branjangan No.28, Ternate

0921-3128188

Standar 11 390000 -

Room Superior 13 490000 -

Room Deluxe 3 590000 -

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8 HOTEL SURYA

PAGI Melati

Jl. Stadion No.7 Ternate

0921-3110999, 0921-328881

Suite Room A 3 375000

Suite Room B 10 450000

Deluxe 11 325000

Superior 9 275000

Standard I 5 250000

Standard II 2 200000

9 ZHAVITRY

HOTEL Melati

Jl. Pattimura No.16 Ternate

081245054846

Standard 8 200000

Deluxe 11 8 250000

Sweet Room 2 315000

10 TERNATE CITY

HOTEL Melati

Jl. Pelabuhan Falajawa 1,

Ternate 0921-3122555

Superior Double 4 290000

Superior Single 18 240000

Standard Double 4 230000

Standard 12 180000

11 HOTEL

NIRWANA Melati

Jl. Pahlawan Revolusi, No.58-60

0921-3123257

Suite Room 1 300000

VIP Room 9 210000

Superior Room 9 4 185000

Standard 6 160000

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LIST OF HOTELS IN TOBELO

No Hotel Name Star

Rating Address Phone # Type

Number of Room

Room Rate

Single Twin Published

Corporate (IDR)

1 VILL A

HERMOSA HOTEL

Melati WOSIA,TOBELO 0924-2621887

VIP 2 350000

DELUXE 16 220000

STANDARD 9 165000

2 HOTEL PRESIDEN Melati JL. Kemakmuran

Tobelo 0924-2621312

VIP 12 275000 / 300000

DELUXE 1 350000

STANDARD 10 220000

SUPERIOR 1 250000

3 ASTONIA HOTEL Melati JL.LANDBOU,

TOBELO 0924-2621377

VIP 4 300000

SUPERIOR 4 225000

STANDARD 1 3 200000

EKONOMY 7 125000 / 150000

4 ZHAFIRA HOUSE Melati JL.MESJID JAMI,

TOBELO 0924-2622100

VIP 4 330000

STANDARD 10 220000

5 HOTEL BIANDA Melati JL.KEMAKMURAN,

TOBELO 0924-2622123

VIP 2 450000

SUPERIOR 5 300000 / 350000

STANDARD 8 240000

6 HOTEL ALFA

OMEGA Melati

Jl. Kemakmuran Tobelo

0924-2622223 VIP 2 1

350000 / 300000

Standard 2 5 250000

7 REGINA HOTEL Melati Jl. Kemakmuran

Tobelo 0924-2621149,

2621437

VVIP 3 385000

VIP 7 7 305000

STANDAR 5 5 220000

8 HOTEL JULIANA Melati Jl. Kemakmuran

Tobelo 0924-2621365

DELUXE 9 250000

SUPERIOR 7 220000

STANDAR 7 100000

9 HOTEL

MORODAI Melati

Jl. Puskesmas Gosoma Tobelo

0924-262294

Family Room 1 275000

Superior 2 250000

Standard 11 100000

10 ELISABETH INN Melati Jl. Kemakmuran,

Depan RS Bethesda, Tobelo

0924-2621165

VIP 7 500000

Deluxe 1 9 330000

Superior 3 12 250000

Standard (single) 3 150000

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11 WISMA PELANGI

AGUNG Melati Gosoma, Tobelo 0924-2621510

Superior 9

250000/ 300000

Extra bed : 50000/malam

12 WISMA MULIA Melati Wosia, Tobelo 0924-2621511 Standard 10 250000

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REGISTRATION FORM I………………………………………….representing……………………………… (Company)

nominate our Emergency Response Team to participate in the 16th Indonesian Fire & Rescue Challenge to be hosted by PT Nusa Halmahera Minerals - Gosowong, North Halmahera County, North Maluku Province from 12 to 22 November 2013. Signed : …………………………………………………

Title : ………………………………………………… (Dept. Head/ Manager Level at minimum)

Contact Details

Telephone/Fax.

: ……………………………………………….

E-mail : ……………………………………………….

Return To

Irwan Hakim

Secretary of the Board Tembagapura 99930 Papua, INDONESIA Phone: 62-0901403008/0901404888 Mobile: 0811492549 & 0811496649 Fax. 62-0901-404235

E-mail [email protected] [email protected]

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