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Pendaftaran ASA
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Nama Lengkap Pendaftar
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Nomor Telepon / Whatsapp
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Nama Sekolah / Kampus / Lembaga
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Alamat Lengkap
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Paket A Space Adventure
Taman Kanak-Kanak
Sekolah Dasar (SD)
Sekolah Menengah Pertama (SMP)
Sekolah Menengah Atas (SMA)
Other:
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Jumlah Anggota Grup (Termasuk Pendamping)
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Tanggal Lawatan
MM
/
DD
/
YYYY
Waktu Lawatan
Time
:
AM
PM
Kesanggupan sumbangan sukarela (Rp)
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Dengan ini kami menyepakati segala ketentuan yang terkait dengan syarat Kunjungan Space Adventure di Griya Antariksa. ( Konfirmasi: 0812-8000-4558 ).
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