THE 39TH IVU WORLD VEGETARIAN CONGRESS 2010 “SAVE OUR LIFE, SAVE OUR PLANET” Jakarta, October 1st - 6th, 2010 & Bali, October 7th - 9th, 2010 PASSPORT DATA   Name First Middle Last Male Female Sex   Passport No.   Issuing Office   Issuing Date   Expire Date   Date of Birth   Nationality CONTACT DETAILS   Postal Address   Phone No.   Mobile Phone No.   Fax No.   Email Address ITINERARY   Arrival 2009 2010 Date    ETA Airlines Flight No.   Departure 2009 2010 Date    ETA Airlines Flight No.         I would like to participate the three days Tour & Seminar to Bali Island       PAYMENT SHOULD BE MADE TO :   Beneficiary : Yayasan KVMI   Bank Name : Bank Mandiri Cabang Sunter Paradise 12011   Bank Address : Jl. Sunter Paradise Blok F20,      No. 45A/B, Sunter - Jakarta Utara   Account No. : 120 00 0622 3270   SWIFT CODE : B E i i i D J As