REGISTRATION FORM iOS FOUNDATION PROGRAM
Apple Developer Academy @ BINUS

PERSONAL INFORMATION

The Foundation Program is a short term, challenge-based class designed to provide the opportunity to aspiring World-Class Developers to experience Apple’s learning framework to design iOS app prototypes. The Foundation will be done in several batches over the year with 35 participants in each batches.

To complete this online registration form, please prepare these documents:

1. Binusian ID (Flazz Card)

2. Citizenship ID (KTP)

Please complete this registration form to join the iOS Foundation online assessment. The schedule and information regarding to the online assessment test will be communicate via email.

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* 1. Full Name (Nama Lengkap)

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* 2. Gender (Jenis Kelamin)

Male (Pria)

Female (Wanita)

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* 3. Email (Please use personal email)

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* 4. Phone Number (Nomor Handphone)
^{Tanpa tanda +62 atau spasi, misal: 08119871188}

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* 5. Binusian ID Number (Nomor Kartu Binusian Flazz Card)
Gunakan nomor ID panjang, misal: 2201234507

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* 6. BINUS Campus (asal Kampus BINUS)

BINUS Jakarta Area (Anggrek-Syahdan-Kijang)

BINUS Alam Sutera

BINUS ASO

BINUS International (JWC Campus)

BINUS Bandung

BINUS Malang

Other BINUS Campus

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* 7. Faculty (Fakultas)

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* 8. Majors (Jurusan)

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* 9. Current Semester (Semester saat ini)

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* 10. Place of Birth (Tempat lahir)

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* 11. Date of Birth (Tanggal Lahir)

DD/MM/YYYY

Date

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* 12. Citizenship ID Number (Nomor KTP)
^{Bila belum memiliki KTP, No. KTP bisa dilihat pada Kartu Keluarga (KK) dalam kolom NIK pribadi.}

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* 13. Citizen ID Address (Alamat sesuai KTP)

Jalan

RT/RW

Kelurahan

Kecamatan

Kota

Kode Pos

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* 14. Current Residential Address (Alamat tempat tinggal saat ini)

Jalan

RT/RW

Kelurahan

Kecamatan

Kota

Kode Pos

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* 1. Full Name (Nama Lengkap)

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* 2. Gender (Jenis Kelamin)

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* 3. Email (Please use personal email)

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* 4. Phone Number (Nomor Handphone)Tanpa tanda +62 atau spasi, misal: 08119871188

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* 5. Binusian ID Number (Nomor Kartu Binusian Flazz Card)Gunakan nomor ID panjang, misal: 2201234507

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* 6. BINUS Campus (asal Kampus BINUS)

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* 7. Faculty (Fakultas)

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* 8. Majors (Jurusan)

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* 9. Current Semester (Semester saat ini)

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* 10. Place of Birth (Tempat lahir)

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* 11. Date of Birth (Tanggal Lahir)

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* 12. Citizenship ID Number (Nomor KTP)Bila belum memiliki KTP, No. KTP bisa dilihat pada Kartu Keluarga (KK) dalam kolom NIK pribadi.

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* 13. Citizen ID Address (Alamat sesuai KTP)

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* 14. Current Residential Address (Alamat tempat tinggal saat ini)

* 4. Phone Number (Nomor Handphone)
^{Tanpa tanda +62 atau spasi, misal: 08119871188}

* 5. Binusian ID Number (Nomor Kartu Binusian Flazz Card)
Gunakan nomor ID panjang, misal: 2201234507

* 12. Citizenship ID Number (Nomor KTP)
^{Bila belum memiliki KTP, No. KTP bisa dilihat pada Kartu Keluarga (KK) dalam kolom NIK pribadi.}