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Registration Form
Please complete the registration form by entering all the required fields.
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Email
*
Your email
Terms & Conditions
Please refer the terms & conditions below:
Reseller Terms & Conditions
Dropship Terms & Conditions (Temporary Closed)
Name
*
Your answer
No. KTP/NPWP
*
We need customer KTP or NPWP because of reasons below:
Your answer
Phone Number
*
Your answer
Address
*
Your answer
Provinces
*
Choose
Aceh
Bali
Banka Belitung Islands
Banten
Bengkulu
Central Java
Central Kalimantan
Central Sulawesi
East Java
East Kalimantan
East Nusa Tenggara
Gorontalo
Special Capital Region of Jakarta
Jambi
Lampung
Maluku
North Kalimantan
North Maluku
North Sulawesi
North Sumatra
Papua
Riau
Riau Islands
Southeast Sulawesi
South Kalimantan
South Sulawesi
South Sumatra
West Java
West Kalimantan
West Nusa Tenggara
West Papua
West Sulawesi
West Sumatra
Special Region of Yogyakarta
Staff Referral
*
Sayyidi Abd Samad
Herry Purnama
Others
Required
Reseller/Dropship Registration Agreement
*
Click here to indicate that you have read and agree to the terms presented in theTerms and Conditions stated above.
Required
Contact Person
After Register, please WhatsApp : +62 81314622369 (Sayyidi) / +62 82111853311 (Herry) or email to :
sayyidi@pelangibooks.com
A copy of your responses will be emailed to the address you provided.
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