University of Nahdlatul Ulama , East Kalimantan Samarinda
Parallel Program - UNU Kaltim Samarinda
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17 Hours Information Services
Tel/Fax : (021) 8762004, 8762002
Mobile/SMS : 0817 0816 486,
0811 1990 9028, 0811 1990 9026
: 0811 1990 9028
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Catalog/Brochure Request Form
FREE via Mail (Post)
If you need a catalog / brochure for your partner (with the same address),
it can be done by writing a few names,
for example : Arif Raharjo, Budi Ahmadi, Cecep Setiawan, and so on.  
We will send you a catalog / brochure in accordance with the number of names written.
If you want the catalog / brochure is also sent to several friends / family
with a different address, then please also fill in Name & Address other (names, addresses, and so on).
Recipient's name
required
Address (Address, Houses No., RT/RW, etc.)
required
City/Province
required
Zip Code
required
Email
can be emptied
Each time you fill the "name" below, then the address, city, and its POS codes are required.
Name 2
can be emptied
Address 2
can be emptied
City/Province 2
can be emptied
Zip Code 2
can be emptied
Name 3
can be emptied
Address 3
can be emptied
City/Province 3
can be emptied
Zip Code 3
can be emptied
Name 4
can be emptied
Address 4
can be emptied
______________
City/Province 4
can be emptied
Zip Code 4
can be emptied
  

Request catalog / brochure can also be done by
send your name and address via SMS to mobile :
0817 0816 486

⊖ Campus UNU KALTIM : Jl. KH. Harun Nafsi Gg. Dharma, Kel. Rapak Dalam Kec. Loa Janan Ilir Samarinda
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UNU Kaltim Samarinda   ●   University of Nahdlatul Ulama , East Kalimantan Samarinda   ●   Quality of Specificity A+