IRMC Registration Form



* Please copy and fill this form and send to miryawan@melsa.net.id or aditya@lintasarta.co.id or you can fill and print this form and send to IRMC, Jl. Sukabumi no.6 Bandung 40271
   
Full name : ...........................................................................................................................
Name on card : ...........................................................................................................................
Address : ...........................................................................................................................
City : ...........................................................................................................................
Zip : ...........................................................................................................................
State/Province : ...........................................................................................................................
Day Phone : ...........................................................................................................................
Night Phone : ...........................................................................................................................
Mobile Phone : ...........................................................................................................................
E-mail : ...........................................................................................................................
Do you have model railroad collection?
Yes, Its from
Scale
What is your favorite model railroad company? ......................................................................
What is your favorite railroad company? ..................................................................................
Other railway collection

Thanks for join us :)


INDONESIAN RAILWAY MODELLERS CLUB
Jl. Sukabumi No.6 Bandung 40271
Telp: (022) 7271955 / 2010795 / 0811-200555. Telp/Fax: (022) 2012957
email:
miryawan@melsa.net.id
http://irmc-online.tripod.com


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