Request for Information Form

YES I want to support ProFauna Indonesia

please send to ProFauna Indonesia the copy of deposit slip

Account number:	53093460
Account name:	PROFAUNA INDONESIA
Bank name:	Bank Negara Indonesia (BNI)
Bank address:	Jl. Basuki Rahmat Malang, Indonesia
Swift code:	BNINIDJAMLG

If you would like to return by post, please send to:

ProFauna Indonesia
Jl. Raya Candi II 179, Klaseman, Karangbesuki
Malang 65146, Jawa Timur-INDONESIA

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