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Japan Indonesia Presidential Scholarships Program
(JIPS)
2010 Application Form
T H E W O R L D B A N K
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Japan Indonesia Presidential Scholarships Program Applicant Information: 2010 Cycle
Introduction Funded by a grant from the government of Japan, the Japan Indonesia Presidential Scholarships Program (JIPS) supports PhD studies in an academic field of study covered by Indonesian Centers of Excellence (CoE) participating in the program. Each of these newly established Centers of Excellence is located at a leading higher education institution in the country with a demonstrated track record in the pursuit of excellence. The goal of the program is to promote excellence in research in these Centers to support the Ministry of National Education in its mission to improve the quality of higher education and research in the country. The purpose of the scholarship is to support scholarship recipients in upgrading their qualifications and to provide them with an international study experience at renowned academic institutions in World Bank member countries, except Indonesia. During their studies, scholars are encouraged to build and foster academic collaborations and partnerships. Upon completion of their studies, the selected candidates commit to work in the sponsoring CoE and play an active role in its academic life. The Centers of Excellence and disciplines covered by the JIPS are as follows:
Institution Center of Excellence
Eligible Disciplines Contact
Bandung Institute of Technology
Biotechnology Environmental Engineering, Bioinformatics, Plant metabolomics and bioprocess
Gadjah Mada University
Good Corporate Governance
Transparency and Disclosure, Disclosure and Accountability, Transparency and Social Responsibility for Transnational Corporation, Corporate Responsibility
Indonesia University of Education
Special Needs Education
Education (Visual Impairment, Hearing Impairment, Students with Intellectual Disability, Physical Impairment)
Institute of Agriculture Bogor (IPB)
Bio-energy Biomolecular plant breeding, Plant Protection, Marine products-based bioenergy production, Biofuel processing development
Bio-industry and Business
Essential oil technology, Rubber and polymer technology, Sugar and sucrochemical technology, Leather technology, Business and commercialization of technology
[email protected]; [email protected]
Open University Distance Learning Management of distance education [email protected]
Parahyangan Catholic University
Small and Medium Enterprise Development (SME)
Industrial Engineering, Product Design and Development, International Political Economy, Accounting, Economics and Business Administration, Management, Commerce/International Business
Infrastructure & Urban Development
Water Resources Planning & Management, Infrastructure Management, Architecture Design & Engineering, Urban Design & Architecture, Hydro informatics, Knowledge management
University of Indonesia
Economic Policy Economics, Public Management, Accountancy
[email protected]; [email protected]
Reproductive Health
Medicine, Biology, Public Health [email protected]
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Length of Scholarship Between three and four years. Scholar’s Commitment Be committed to work as professor/researcher in the Centers of Excellence endorsing the scholarship upon completion of the PhD Program. Eligibility Applicants must meet the following general criteria to be eligible for a scholarship: • be a national and resident of Indonesia • be under 45 years at application deadline. • must have completed and been awarded a master's degree, or equivalent, at the time of application
however, outstanding candidates with a bachelor degree can be considered for a Master-PhD track • have maintained a GPA of at least 3 on a scale of 4 in both undergraduate and graduate studies
Application Procedures Application forms and information about the application procedure are available in the participating Centers of Excellence, and on the World Bank Scholarship Program website at www.worldbank.org/scholarships. Interested candidates should submit application packages by March 26, 2010 to the relevant Center of Excellence of their choice using the contact information provided in Attachment B. Preselected candidates will be invited to an interview end of April 2010. For specific inquiries about the scholarship positions and additional selection criteria, interested candidates are invited to contact the respective Center of Excellence directly. For general inquiries, the Program Office can also be contacted at:
Japan Indonesia Presidential Scholarships Program The World Bank
MSN J4-402 1818 H St. NW
Washington DC, 20433, USA email: [email protected]
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Instructions for Completing the Application Form
There are 7 sections in this application.
• Personal Data • Academic Background • University Study Program • Work Experience • Relevance of Proposed Research Activity • References • Checklist
• Underline the name by which you would be addressed with a title, e.g., Satrio Sudiatmo = Mr. Satrio • You must submit proof of your nationality with the application • You must also submit proof of your date of birth
Note: applicants must be under 45 years at application deadline
In this section you should list your highest degree first, followed by postgraduate diplomas and undergraduate degree. Send a copy of your highest degree. If applicable, please include copies of all post-graduate diplomas. Please write out the complete title of your degree, along with the acronym. All certificates must
be translated into English.
In section C.1 you should indicate if you have admission to a master’s degree, PhD or None. In Section C.2 you should indicate two preferences of universities where you would like to pursue your studies.
In Section D.1 you should indicate if you are currently a staff in one of the Centers of Excellence. In Section D.2 you should give detailed information on each full-time position held by you, listing your current or most recent occupation first. Emphasis should be given to activities with particular relevance to your research.
A. Personal Data: Page 1
B. Academic Background: Page 2
C. University Study Program: Pages 3
D. Work Experience: Pages 6
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Please provide a brief description of the objectives and potential contribution of your study program. We would also like you to specify the relevance of this study program to your past professional experience and future career goals.
Please provide the names and addresses of two or more individuals who will provide us with reference letters. Special forms for “Letters of Reference” are provided in Attachment A. We strongly recommend that you enclose the sealed letters of reference along with your completed application package, to eliminate the possibility of late arrival. In all cases, the letters of Reference need to arrive no later than the application deadline, March 26, 2010.
You should select referees who are competent to comment on: • Your academic strengths and achievements • Your professional experience in teaching and research • Your ability to successfully complete the doctoral study you propose • The relevance of the proposed program of study to the corresponding CoE Letters must be dated within 3 months of their submission to the Program.
All specified enclosures must be included in the completed application package.
E. Relevance of Proposed Study Program: Page 9
F. References: Page 10
G. Checklist: Page 11
Applicant’s Name: ______________________________________________________________________ Family/Last Name First Name Middle Name
Japan Indonesia Presidential Scholarships Program - The World Bank
1818 H Street, N.W., MSN J4-402, Washington, D.C. 20433, USA
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Japan Indonesia Presidential Scholarships Program 2010 Application Form
1. Name:________________________ _________________________ ______________________ Last (Family) First Middle 2. Gender: Male _______ Female ________ 3. Nationality: __________________________ 4. Permanent Address: _______________________________________________________________ (Street Address) ___________________________________________________________________________________ (City) (State/Region) (Postal Code) (Country) Telephone: __________________________________ Fax: __________________________________ E-mail: _____________________________________________________________________________ 5. Current Address: __________________________________________________________________
(if different from above) (Street Address) __________________________________________________________________ (City) (State/Region) (Postal Code)
(Country) Telephone: __________________________________ Fax: __________________________________ Telephone (Office):____________________________ Fax (Office): ___________________________ E-mail: _____________________________________________________________________________ 6. Date of Birth: ______________________________ 7. Age: ______________________________ (Day) (Month) (Year) 8. Highest Degree Held: ______________________ 9. Degree in Progress: __________________ Expected Date of Completion: __________ 10. Current Occupation (Please mark one): _______ Academic _______ Public Sector (other than academic) _______ Private Sector
_______ Regional or International Organization _______ NGO _______ Consultant _______ Other, please specify: ______________________
11. Education level of your parents: Mother Father No Education _______ _______ Primary _______ _______ Secondary _______ _______ University _______ _______
A. Personal Data: Summary
Applicant’s Name: ______________________________________________________________________ Family/Last Name First Name Middle Name
Japan Indonesia Presidential Scholarships Program - The World Bank
1818 H Street, N.W., MSN J4-402, Washington, D.C. 20433, USA
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Name of Institution: ___________________________________________________________________ Address: ____________________________________________________________________________ ___________________________________________________________________________________ Duration of the Degree Program: __________________ Dates Attended: From: _______ To: ________ month/year month/year Degree Awarded: _____________________________________________________________________ Subjects/Field: _______________________________________________________________________ Name of Institution: ___________________________________________________________________ Address: ____________________________________________________________________________ ___________________________________________________________________________________ Duration of the Degree Program: __________________ Dates Attended: From: _______ To: ________ month/year month/year Degree Awarded: _____________________________________________________________________ Subjects/Field: _______________________________________________________________________ Name of Institution: ___________________________________________________________________ Address: ____________________________________________________________________________ ___________________________________________________________________________________ Duration of the Degree Program: __________________ Dates Attended: From: _______ To: ________ month/year month/year Degree Awarded: _____________________________________________________________________ Subjects/Field: _______________________________________________________________________
B. Academic Background (highest degree first)
Applicant’s Name: ______________________________________________________________________ Family/Last Name First Name Middle Name
Japan Indonesia Presidential Scholarships Program - The World Bank
1818 H Street, N.W., MSN J4-402, Washington, D.C. 20433, USA
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Do you have admissions to: Master’s Degree PhD None
University Admission (1):
University: ________________________________________________________________
Degree Name: ______________________________________________________________
Start Date (mm/yyyy): _______________ End Date (mm/yyyy): ______________________
Contact Person: _______________________________ Title: ________________________ (Family/Last Name) (First Name)
Office Telephone: ______________________ Fax: __________________________
Email: ____________________________________________________________________
University Admission (1):
University: ________________________________________________________________
Degree Name: ______________________________________________________________
Start Date (mm/yyyy): _______________ End Date (mm/yyyy): ______________________
Contact Person: _______________________________ Title: ________________________ (Family/Last Name) (First Name)
Office Telephone: ______________________ Fax: __________________________
Email: ____________________________________________________________________
C.1 University Study Program
Applicant’s Name: ______________________________________________________________________ Family/Last Name First Name Middle Name
Japan Indonesia Presidential Scholarships Program - The World Bank
1818 H Street, N.W., MSN J4-402, Washington, D.C. 20433, USA
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Language proficiency rating
Language Excellent Good Fair English
Other (specify)
Other (specify)
Other (specify)
Other (specify) Standard Tests
Test Date Score
TOEFL
GRE
GMAT
IELTs
Other (specify)
Applicant’s Name: ______________________________________________________________________ Family/Last Name First Name Middle Name
Japan Indonesia Presidential Scholarships Program - The World Bank
1818 H Street, N.W., MSN J4-402, Washington, D.C. 20433, USA
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In case you need a university admission, please indicate below your preferences in order of priority: University Admission (First Preference)
University/Institution name: _____________________________________________________________
Faculty/School/Department _____________________________________________________________
Lab/Research team: __________________________________________________________________
Have you already started the application process? Yes No
If yes, is there a contact person? ________________________________________________________ (Family/Last Name) (First Name)
Title: _______________________________________________________________________________
Office Telephone: _____________________________ Fax: ________________________________
Email: ______________________________________________________________________________
University Admission (Second Preference)
University/Institution name: _____________________________________________________________
Faculty/School/Department _____________________________________________________________
Lab/Research team: __________________________________________________________________
Have you already started the application process? Yes No
If yes, is there a contact person? ________________________________________________________ (Family/Last Name) (First Name)
Title: _______________________________________________________________________________
Office Telephone: _____________________________ Fax: ________________________________
Email: ______________________________________________________________________________
C.2 University Study Program
Applicant’s Name: ______________________________________________________________________ Family/Last Name First Name Middle Name
Japan Indonesia Presidential Scholarships Program - The World Bank
1818 H Street, N.W., MSN J4-402, Washington, D.C. 20433, USA
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Are you currently a staff in one of the following Centers of Excellence? Yes No If you answered yes to the question above, indicate the position and start date of service in the corresponding line:
Institution Center of Excellence Position Held Date of Service
Bandung Institute of Technology Biotechnology
Gadjah Mada University Good Corporate Governance
Indonesia University of Education Special Needs Education
Institute of Agriculture Bogor (IPB)
Bio-energy
Bio-industry and Business
Open University Distance Learning
Parahyangan Catholic University
Development of SME
Infrastructure & Urban Development
University of Indonesia Economics
Reproductive Health
D1. Work Experience
Applicant’s Name: ______________________________________________________________________ Family/Last Name First Name Middle Name
Japan Indonesia Presidential Scholarships Program - The World Bank
1818 H Street, N.W., MSN J4-402, Washington, D.C. 20433, USA
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Give a record of each of the last full-time positions held (most recent first). This application form includes two pages (6 and 7) for information on your employment history. List part-time jobs, community service and other activities on page 8. Organization: _________________________________________________________ Public Sector Private Sector NGO Regional or International Organization Address: ____________________________________________________________________________ ___________________________________________________________________________________ Telephone: ___________________________________ Fax/E-Mail _____________________________ Title of Supervisor’s your Position __________________________________ Name: ________________________________ Dates of Service: From: _________________________ To: ___________________________________ (month/year) (month/year) Please provide details of your professional responsibilities, project(s) undertaken, and other professional accomplishments in the space below. Organization: _________________________________________________________ Public Sector Private Sector NGO Regional or International Organization Address: ____________________________________________________________________________ ___________________________________________________________________________________ Telephone: ___________________________________ Fax/E-Mail _____________________________ Title of Supervisor’s your Position __________________________________ Name: ________________________________ Dates of Service: From: _________________________ To: ___________________________________ (month/year) (month/year) Please provide details of your professional responsibilities, project(s) undertaken, and other professional accomplishments in the space below.
D.2 Other Work Experience (begin with current or most recent position)
Applicant’s Name: ______________________________________________________________________ Family/Last Name First Name Middle Name
Japan Indonesia Presidential Scholarships Program - The World Bank
1818 H Street, N.W., MSN J4-402, Washington, D.C. 20433, USA
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Part-time jobs, community service, and other relevant activities. ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ Other information, related to your professional and personal development, which is relevant to your application. ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________
Applicant’s Name: ______________________________________________________________________ Family/Last Name First Name Middle Name
Japan Indonesia Presidential Scholarships Program - The World Bank
1818 H Street, N.W., MSN J4-402, Washington, D.C. 20433, USA
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1. Please specify briefly the research topic you intend to address in your doctoral study (150 words maximum). ___________________________________________________________________________________ 2. Please specify the relevance of the proposed research activity to your past professional experience, and future academic career (150 words maximum).
E. Relevance of Proposed Studies
Applicant’s Name: ______________________________________________________________________ Family/Last Name First Name Middle Name
Japan Indonesia Presidential Scholarships Program - The World Bank
1818 H Street, N.W., MSN J4-402, Washington, D.C. 20433, USA
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Name: _________________________________________ Title: ____________________________________ Address: _________________________________________________________________________________ (Street Address) ________________________________________________________________________________________ (City) (State/Region) (Postal Code) (Country) Telephone: ______________________________________ Fax: ____________________________________ Email: ___________________________________________________________________________________
In what capacity do you know this referee? ________________________________________________ Name: _________________________________________ Title: ____________________________________ Address: _________________________________________________________________________________ (Street Address) ________________________________________________________________________________________ (City) (State/Region) (Postal Code) (Country) Telephone: ______________________________________ Fax: ____________________________________ Email: ___________________________________________________________________________________
In what capacity do you know this referee? ________________________________________________
F. References
Applicant’s Name: ______________________________________________________________________ Family/Last Name First Name Middle Name
Japan Indonesia Presidential Scholarships Program - The World Bank
1818 H Street, N.W., MSN J4-402, Washington, D.C. 20433, USA
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You must submit the completed application form and attach the following documents • Copy of your highest degree and proof of any additional post-graduate diplomas • Admission to a master’s degree or PhD program • Two letters of reference (Attachment A) • A current or updated curriculum vitae not exceeding two pages • Proof of nationality
• Proof of date of birth
All certificates must be translated into English. I certify that the information contained in this application form is accurate to the best of my knowledge.
If awarded a Fellowship, I agree to abide by the terms of the award and to undertake the program essentially as outlined in this proposal. I also understand and accept that the World Bank reserves the right to publish the product of my study or research.
Please note that applicants are responsible for obtaining all clearances that may be required to undertake the proposed study or research, including any necessary clearance or permission of the Government of Indonesia and of your employer.
___________________________________ ____________________ (Signature) (Date)
Applications must reach the Japan Indonesia Presidential Scholarships Program Office at the following address, no later than March 26, 2010, to be considered for the 2010 Cycle.
Faxed applications are not accepted.
G. Checklist
Applicant’s Name: ______________________________________________________________________ Family/Last Name First Name Middle Name
Japan Indonesia Presidential Scholarships Program - The World Bank
1818 H Street, N.W., MSN J4-402, Washington, D.C. 20433, USA
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Japan Indonesia Presidential Scholarships Program
The World Bank, 1818 H Street, N.W. MSN J4-402 Washington D.C., 20433, U.S.A.
LETTER OF REFERENCE (Professional or Academic)
Referee’s Name: _______________________________________________________________________ Title: _______________________________________________________________________________ Organization: __________________________________________________________________________ Address: ______________________________________________________________________________ Telephone: ___________________________________ Fax _____________________________________ E-Mail _______________________________________________________________________________ 1. How long have you known the applicant? __________________________________________________ 2. In what capacity? ____________________________________________________________________ To the Referee: Your assessment of the above-named applicant is an important part of the scholarship program’s review process. The questions posed below represent the kind of information which the reviewers find useful, but you are welcome to give us your views in whatever format you find most suitable. The letter of recommendation is confidential. Please return the completed form/letter to the applicant in a sealed envelope with your signature across the flap.
Applications must be received, no later than
March 26, 2010, to be considered for the 2010 Cycle. Faxed applications are not accepted.
Attachment A
Applicant’s Name: ______________________________________________________________________ Family/Last Name First Name Middle Name
Japan Indonesia Presidential Scholarships Program - The World Bank
1818 H Street, N.W., MSN J4-402, Washington, D.C. 20433, USA
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1. Please describe the applicant’s academic or professional strengths and achievements. 2. On a scale of 1 to 3, with 1 being the highest, what is your assessment of the applicant’s academic
preparation to successfully carry out the proposed doctoral study? In addition to your rating, we are interested in having your viewpoint on this important factor.
Rating Scale (Please Circle): 1 2 3
Applicant’s Name: ______________________________________________________________________ Family/Last Name First Name Middle Name
Japan Indonesia Presidential Scholarships Program - The World Bank
1818 H Street, N.W., MSN J4-402, Washington, D.C. 20433, USA
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3. Additional Comments. Signature of Referee ____________________________________ Date:________________________
Attachment B CoE Contact Information
Japan Indonesia Presidential Scholarships Program - The World Bank 1818 H Street, N.W., MSN J4-402, Washington, D.C. 20433, USA
CoE Contact Person Title Office Telp/HP Email Mailing Address BANDUNG INSTITUTE OF TECHNOLOGY
Biotechnology Dr. Maelita R.
Moeis Coordinator of the COE of Biotechnology
022 2500 258/ 0813 22360 525
[email protected] SITH ITB, Gedung LABTEK XI Jl. Ganesha No. 10 Bandung, West Java Indonesia 40132
GADJAH MADA UNIVERSITY
Good Corporate Governance
Dr. Sony Warsono Executive Director-Center for Good Governance
0274 548 550/ 08179423068
[email protected] Centre for Good Corporate Governance Fakultas Ekonomika & Bisnis Universitas Gadjah Mada Jl. Sosio Humaniora No. 1 Bulak Sumur DI Yogyakarta Indonesia 55281
INDONESIA UNIVERSITY OF EDUCATION
Special Needs Education
Dr. Djaja Rahardja Coordinator of the COE of Special Needs Education
022 201 3161/ 0818 426 532
[email protected] Fakultas Ilmu Pendidikan Jurusan Pendidikan Luar Biasa Jl. Dr. Setiabudhi No. 229 Bandung, West Java, Indonesia 40154
Attachment B CoE Contact Information
Japan Indonesia Presidential Scholarships Program - The World Bank 1818 H Street, N.W., MSN J4-402, Washington, D.C. 20433, USA
CoE Contact Person Title Office Telp/HP Email Mailing Address
INSTITUTE OF AGRICULTURAL BOGOR (IPB)
Bio-Energy Dr Ir. Anas M.
Fauzi Vice-Rector for Research and Collaboration
0251 8622 637/ 0811 1185 08
[email protected] Wakil Rektor Bidang Research & Kerjasama Gedung Andi Hakim Nasuton 2nd Floor Kampus IPB Rektorat Jl. Raya Darmaga Bogor West Java Indonesia 16680
Bio-Industry and Business
Dr Muhammad Agil
Head of Sub Directorate for International Programs
0251 8622 638/ 0812 950 5081
[email protected]; [email protected]
Direktorat Kerja Sama & Progoram International Gedung Andi Hakim Nasuton 2nd Floor Kampus IPB Rektorat Jl. Raya Darmaga Bogor West Java Indonesia 16680
OPEN UNIVERSITY Distance Learning Dr Tian Belawati Vice-Rector for
Academic Affairs 021 749 0941 ext 1105
[email protected] Gedung Rektorat 1st Floor, Jl. Cabe Raya, Pondok Cabe, Tangerang Banten West Java Indonesia 15418
Attachment B CoE Contact Information
Japan Indonesia Presidential Scholarships Program - The World Bank 1818 H Street, N.W., MSN J4-402, Washington, D.C. 20433, USA
CoE Contact Person Title Office Telp/HP Email Mailing Address
PARAHYANGAN CATHOLIC UNIVERSITY
Infrastructure & Urban Development
Prof Robertus Wahyudi Triweko, Ph. D
Coordinator of the COE of Infrastructure & Urban Development
022 203 691/ 0812 232 7972
[email protected] Gedung Dekanat Fakultas Teknik UNPAR Jl. Cimbeleuit No. 94 Bandung West Java Indonesia 40141
Small and Medium Enterprise Development
Prof Anak Agung Banyu Perwita Ph. D.
Vice Rector for Relations and Cooperation
022 203 2655/ 2032576 ext. 100/ 0812 204 4951
[email protected] Gedung Rektorat UNPAR 2nd Floor Jl. Cimbeleuit No. 94 Bandung West Java Indonesia 40141
UNIVERSITY OF INDONESIA
Economic Policy Dr. Jossy P. Moeis
and Dr. Firmanzah Manager Research Community Service and Academic Development
0811904751/ 727 2425 [email protected] and [email protected]
Manager Research & Pengabdian Masyarakat Gedung Dekanat Fakultas Ekonomi, Universitas Indonesia Kampus UI Depok West Java Indonesia 16424
Reproductive Health Dr Budi Wiweko Head of the COE of Reproductive Health
0816 144 0025 [email protected] Department of Obstetry & Gynecology Fakultas Kedokteran UI/RSCM Jl. Diponegoro No. 71 Jakarta Pusat Indonesia 10340
