Workshop Registration

Sign-Up form for Offline Workshop & Event Submission

Full Name *

Are you Indonesian (WNI) or Foreigner? * Indonesian (WNI)Foreigner

KITAS Details *

IMTA Job Title *

IMTA Number*

Email *

Phone / Whatsapp *

Telegram Username *

Teachers certificate * Please Upload Your Certificate

Your Bio *

Instagram Account *

Social Media Hashtags *

Social Media Details/Captions *

Event Description

Title of The Event *

Extended / full description of the Event *

Short description of event for poster *

Choose Your Type of Events *

Where do you wanna do the event? *

Price in IDR (Indonesian Rupiah) *

Early bird price *

Do you need photographer and videographer during your session? *

When and what time do you want to do your event? *

Any Special Requirements needed during your offering? * Example: microphones, print outs, white board, candles, projector, special clothes etc.

I’ve read and understand that Moana Wellness Hub will not be responsible for any illegal work without a valid KITAS Kerja (work visa) and IMTA (work license).

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