Formulir Pendaftaran Mpmkm.docx
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MAJELIS PERMUSYAWARATAN MAHASISWA KELUARGA MAHASISWA POLITEKNIK KESEHATAN KEMENTERIAN KESEHATAN ACEH JL. Soekarno-Hatta Kampus Terpadu Poltekkes Kemenkes Aceh,Lampenerut,Banda Aceh, Aceh , Indonesia, pos :23352 follow Intagram: mpmpoltekkesaceh
FORMULIR PENDAFTARAN CALON PENGURUS MPM-KM POLITEKNIK KESEHATAN KEMENKES ACEH 2019-2020
Yang bertanda tangan dibawah ini : Nama : Tempat Tanggal Lahir : Jenis Kelamin : NIM : Jurusan/prodi : Alamat : No.Hp : Email : Motto Hidup : PENDIDIKAN SD : SMP/MTS : SMA/MAN : PENGALAMAN ORGANISASI 1. …………………………………………………………………………………………………………………………… 2. ……………………………………………………………………………………………………………………………. 3. ……………………………………………………………………………………………………………………………. 4. ……………………………………………………………………………………………………………………………. 5. …………………………………………………………………………………………………………………………….
Banda Aceh, Calon Pengurus MPM-KM 4X6
(…………………………………..)
FORMULIR PENDAFTARAN CALON PENGURUS MPM-KM POLITEKNIK KESEHATAN KEMENKES ACEH 2019-2020
Yang bertanda tangan dibawah ini : Nama : Tempat Tanggal Lahir : Jenis Kelamin : NIM : Jurusan/prodi : Alamat : No.Hp : Email : Motto Hidup : PENDIDIKAN SD : SMP/MTS : SMA/MAN : PENGALAMAN ORGANISASI 1. …………………………………………………………………………………………………………………………… 2. ……………………………………………………………………………………………………………………………. 3. ……………………………………………………………………………………………………………………………. 4. ……………………………………………………………………………………………………………………………. 5. …………………………………………………………………………………………………………………………….
Banda Aceh, Calon Pengurus MPM-KM 4X6
(…………………………………..)
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