Formulir Dbs

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PT. DUTA FUTURE INTERNASIONAL Surapati Core Blok J7 Jl. PH Mustofa No 39 BANDUNG Telp. 022 761 76022

STOKIS PAMEKASAN JL. VETRAN G/VII Pamekasan Hp. 081 931 098 961(Basri) Hp. 08175001031 (Uus)

www.duta4future.com

FORMULIR MEMBER Sponsor ( User ID) : …………………………………………………………………………………………………………….. Nama : …………………………………………………………………………………………………………….. Tempat/ Tgl Lahir : …………………………………………………………………………………………………………….. Ibu Kandung : …………………………………………………………………………………………………………….. No HP : …………………………………………………………………………………………………………….. Alamat : …………………………………………………………………………………………………………….. No Identitas : …………………………………………………………………………………………………………….. Password : …………………………………………………………………………………………………………….. Nama BANK : …………………………………………………………………………………………………………….. Nama Pemilik : …………………………………………………………………………………………………………….. No Rekening : …………………………………………………………………………………………………………….. Ahli Waris : …………………………………………………………………………………………………………….. Status : …………………………………………………………………………………………………………….. Jumlah HU : ……………………………………………………………………………………………………………..

Kesuksesan adalah hak setiap orang, tidak ada satu orang pun yang bias menghalangi anda untuk sukses kecuali diri anda. Masa depan kita tidak ditentukan oleh latar belakangnya, tidak ditentukan oleh masa lalunya, tetapi ditentukan oleh keputusan anda. GO FREEDOM New Member

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