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Instructions
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Step
1
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Registration Fee
Please upload your registration payment receipt.
Registration Payment Receipt
*
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Recommendation 2MB, tolerance up to 5MB per file. Allowed file: JPG, JPEG, PNG, BMP, PDF
PROGRAM
*
PROFESSIONAL CHEF CULINARY
PROFESSIONAL CHEF PASTRY BAKERY
THE APURVA CHEF
PASTRY BAKERY INTENSIVE
CARPIGIANI GELATO COURSE
INTRODUCTION TO WINE CLASS (WSET LEVEL 1)
HOLIDAY PROGRAM
Intake Year
*
2023
2024
2025
All Prepare Documents ready
*
All document and requirement are ready
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Personal Information
Salutation
*
Mr.
Mrs.
Ms.
Full Name
*
Date of Birth
*
Gender
*
Male
Female
ID Type
*
KTP/NIK (Recommended)
Driver License
Passport
Student Card
* Your NIK is available on your KTP and listed on KK (Kartu Keluarga)
ID Number
*
Religion
*
Buddhist
Christian
Catholic
Hindu
Moeslm
Khong Hu Cu
Others
Nationality
*
Indonesian
Non Indonesian
Country
*
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Côte d'Ivoire
Cabo Verde
Cambodia
Cameroon
Canada
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo (Congo-Brazzaville)
Costa Rica
Croatia
Cuba
Cyprus
Czechia (Czech Republic)
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (fmr. "Swaziland")
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Holy See
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar (formerly Burma)
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
North Korea
North Macedonia
Norway
Oman
Pakistan
Palau
Palestine State
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Sweden
Switzerland
Syria
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Email
*
Primary Contact
*
*WhatsApp Available
Alternate Contact
Marital Status
*
Married
Single
Sponsorship Type
*
Self-Sponsored
Parents
Company-Sponsored
Social Media Information
Facebook
Instagram
English Language Proficiency
How well do you speak English?
*
Least Fluent
Average
Fluent
Very Fluent
Have you studied at secondary or tertiary level with English as the language of instruction?
Yes
No
Additional Information
How do you know about us?
*
Advertisement
Instagram
Facebook
Website
Search Engine
Education Exhibition
Event Reference
Newspaper
Other
Referrer Name
*Please enter the person's name who refer you to register a program at Bali Culinary Pastry School
Bali Culinary Pastry School representative
*Please enter the name of Bali Culinary Pastry School representative who shared/assisted you for this program registration.
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Address Information
Residential Address
*
Address Line 1
City
State / Province / Region
Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bonaire, Saint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo (Democratic Republic of the)
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Kingdom of)
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland (Republic of)
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea (Democratic People's Republic of)
Korea (Republic of)
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia (Federated States of)
Moldova (Republic of)
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia (Republic of)
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine (State of)
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Republic of China
Tajikistan
Tanzania (United Republic of)
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
Uganda
Ukraine
United Arab Emirates
United Kingdom of Great Britain and Northern Ireland
United States Minor Outlying Islands
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City State
Venezuela (Bolivarian Republic of)
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Family Information
Father’s Full Name
*
Father’s Occupation
*
Father’s Residential Address
*
Father’s Date of Birth
*
Father’s Education
*
Elementary School / SD
Junior High School / SMP
High School / SMA
Associate's Degree / D3
Bachelor's Degree / S1
Master's Degree / S2
Father’s Email
Father’s Primary Contact
*
Father’s Salary Range (per month)
*
IDR 10 – 15 million
IDR 16 – 20 million
IDR 21 – 30 million
> 30 million
Others
Mother's Full Name
*
Mother's Occupation
*
Mother's Residential Address
*
Mother's Date of Birth
*
Mother's Education
*
Elementary School / SD
Junior High School / SMP
High School / SMA
Associate's Degree / D3
Bachelor's Degree / S1
Master's Degree / S2
Mother's Email
Mother's Primary Contact
*
Mother's Salary Range (per month)
*
IDR 10 – 15 million
IDR 16 – 20 million
IDR 21 – 30 million
> 30 million
Others
Guardian's Personal Information
Do you have any representative other than parents?
(legal spouse, adopted parents)
Guardian
Yes
No
Representative's Personal Information
Representative's Full Name
Representative's Occupation
Representative's Residential Address
Representative's Education
Elementary School / SD
Junior High School / SMP
High School / SMA
Associate's Degree / D3
Bachelor's Degree / S1
Master's Degree / S2
Representative's Date of Birth
Representative's Email
Representative's Primary Contact
Representative's Salary Range (per month)
≥ Rp 10.000.000
Rp 6.000.000 - Rp. 10.000.000
Rp3 .000.000 - Rp. 6.000.000
Rp 1.500.000 - Rp. 3.000.000
Other
Emergency Contact Information
* MUST BE COMPLETED
Person to be contacted in case of emergency if parent are not available.
Emergency Contact Name
*
Emergency Contact Mobile Phone
*
Emergency Contact Email
*
Relationship
*
Brother
Sister
Cousin
Uncle
Aunt
Others
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Declaration
Acknowledgement
Have you ever been arrested by the Police or convicted of a criminal offence?
*
Yes
No
Acknowledgement Arrested by police
Have you ever been dismissed from employementor misconduct or poor performance?
*
Yes
No
Acknowledgement dismissed from employementor
Have you ever been subjected to sanction or discipline by any academic institution?
*
Yes
No
Acknowledgement saction discipline
Are you suffering from any chronic illness/disease?
*
Yes
No
Acknowledgement chronic illness
Do you have disability impalment / long term medical condition that may affect your studies ?
*
Yes
No
If Yes please indicate area of impalment
Hearing
Medical
Vision
Mobility
Learning
Other
Acknowledgement implant
Have you had any medical surgery in the past 5 years?
*
Yes
No
Acknowledgement
Have you suffered/are suffering from any form of mental illness?
*
Yes
No
Acknowledgement
Have you received medical treatment for congenital or physical disability in past or present?
*
Yes
No
Acknowledgement
Would you consider pursuing a degree once completing of the Bali Culinary Pastry School Professional Programme?
*
Yes
No
Acknowledgement - consider pursuing
Acknowledgement
*
I have read and understood the acknowledgement below
I AGREE WITH THE TERMS AND CONDITIONS THAT FOLLOW AND DECLARE THAT THE PARTICULARS GIVEN IN THIS APPLICATION FORM ARE COMPLETE AND TRUE.
1. I understand application fee is non-refundable and non-transferable.No refunds will be given, for any reason whatsoever, for students who fail to complete the test at Bali Culinary Pastry School.
2. I certify that the information supplied by me on all parts of this form is complete and true
3. I understand that Indonesia College may refuse, vary, reverse or terminate my enrollment on the basis of untrue, misleading or incomplete information.
4. I am aware of and have sighted Indonesia college Privacy Policy and Code of practise, available on the institutes website and agree to them.
5. I give permission to Indonesia College will not provide or disclose to any
third parties my personalinformation without my concent.
6. However, if require by law then the information will be released.
7. I give Permission to Indonesia College to keep my photo identification for
ID card purpose and for identification purposes.
8. I Have also read the student hand book, to be aware of all the policies
and procedures pertaining to the college.
9. I promise any drugs, narcotics, crime are not allowed to enter in the school.
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Students Statement
Why did you decide to apply to Bali Culinary Pastry School? Please share the experiences that make you realize that learning culinary is a goal
*
What is your goal for the next 5 years after completing your study in the school.
*
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DOCUMENT SUBMISSION
ID Card/Passport
*
Click or drag files to this area to upload.
You can upload up to 2 files.
Photos 3x4
*
Click or drag files to this area to upload.
You can upload up to 2 files.
Family Card
*
Click or drag a file to this area to upload.
Transcript
*
Click or drag files to this area to upload.
You can upload up to 2 files.
Highest Education Qualification Certificate
*
Click or drag files to this area to upload.
You can upload up to 2 files.
Birth Certificate
*
Click or drag a file to this area to upload.
Sponsor Commitment
*
Click or drag a file to this area to upload.
Recommendation Letter
*
Click or drag files to this area to upload.
You can upload up to 3 files.
Resume/CV
*
Click or drag a file to this area to upload.
Recommendation 2MB, tolerance up to 5MB per file. Allowed file: JPG, JPEG, PNG, BMP,PDF (Documents) JPG, JPEG, PNG, BMP, TIFF (Photograph)
Video Personal Statement
Video duration maximum 5 minutes uploaded on
Youtube.
Video
*
Uploaded Video Link (Youtube)
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