Formulir Pendaftaran Bem Fk Pengurus.docx

KOMISI PEMILIHAN PENGURUS BEM FK UNIVERSIYAS SARI MULIA BANJARMASIN Alamat : Jl. Pramuka No.02 Banjarmasin Telp. 0551-3268105. E-mail : [email protected]

FORMULIR PENDAFTARAN CALON PENGURUS BEM FAKULTAS KESEHATAN 1. Data Diri  Nama Lengkap :  Nama Panggilan :  Tempat/tgl lahir :  NIM :  IPK :  No. HP :  Email :  Jurusan : 2. Pengalaman Organisasi No Nama Organisasi

Jabatan

Tahun

3. Pengalaman Kepanitiaan No Nama Kegiatan

Jabatan

Tahun

4. Prestasi

5. Apa yang anda ketahui tentang Badan Eksekutif Mahasiswa (BEM)? ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________

KOMISI PEMILIHAN PENGURUS BEM FK UNIVERSIYAS SARI MULIA BANJARMASIN Alamat : Jl. Pramuka No.02 Banjarmasin Telp. 0551-3268105. E-mail : [email protected]

___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 6. Apa yang melatarbelakangi anda tertarik untuk berorganisasi? ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 7. Dalam hidup, setiap orang pasti pernah dihadapkan pada kesuksesan dan kegagalan. Saya ingin mengetahui bagaimana cara anda menyikapi kesuksesan dan kegagalan dalam perjalanan hidup anda? ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 8. Bagaimana dengan cara anda menjalin hubungan antar rekan dalam organisasi. Baik kepada teman yang berada pada level atas (ketua) atasan ataupun teman pada level yang sama dengan anda (sesama anggota)? ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________

KOMISI PEMILIHAN PENGURUS BEM FK UNIVERSIYAS SARI MULIA BANJARMASIN Alamat : Jl. Pramuka No.02 Banjarmasin Telp. 0551-3268105. E-mail : [email protected]

___________________________________________________________________ 9. Bagaimana cara anda menyikapi teman kerja yang tidak menyenangkan? ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 10. Bagaimana cara anda menjalin hubungan antar rekan dalam organisasi, baik kepada teman yang berada pada level atas (ketua) ataupun teman pada level yang sama dengan anda (sesama anggota)? ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 11. Bagaimana cara anda menyikapi teman yang tidak menyenangkan? ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 12. Bagaimana cara anda menyelesaikan sebuah konflik atau kesalahpahaman yang mungkin terjadi di dalam organisasi ? ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 13. Apa yang anda lakukan bila menemukan teman yang bekerja asal-asalan dan terlihat malas, sementara dia adalah bagian dari team anda? ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 14. Apabila anda diminta untuk memilih, anda lebih senang bekerja sendiri atau secara kelompok. Mengapa demikian? ___________________________________________________________________

KOMISI PEMILIHAN PENGURUS BEM FK UNIVERSIYAS SARI MULIA BANJARMASIN Alamat : Jl. Pramuka No.02 Banjarmasin Telp. 0551-3268105. E-mail : [email protected]

___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ Visi ............................................................................................................................... ...................................................................................................................................... ...................................................................................................................................... ...................................................................................................................................... ...................................................................................................................................... ...................................................................................................................................... Misi .............................................................................................................................. ...................................................................................................................................... ...................................................................................................................................... ...................................................................................................................................... ...................................................................................................................................... ...................................................................................................................................... PROGRAM KERJA

Dengan ini saya menyatakan, pengisian formulir ini saya lakukan dengan penuh kesadaran serta kebenaran yang dapat dipertanggung jawabkan.

Calon Ketua/Wakil Foto 3x4 (…………………………)