Formulir Pkd.docx
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PANITIA PELATIHAN KADER DASAR PENGURUS KOMISARIAT PERGERAKAN MAHASISWA ISLAM INDONESIA (Commisariat Board of Indonesian Moslem Student Movement)
FAKULTAS EKONOMI DAN BISNIS V-03
Jl. Semanggi II Ciputat 15412 Tangerang Selatan Telp. 0822 9868 2414 email: [email protected] Website : www.pmii-komfeis.or.id
Formulir Pendaftaran Nama
: ___________________________________________________________
Tempat/ Tgl Lahir
: ___________________________________________________________
Jenis Kelamin
: ___________________________________________________________
Alamat
: ___________________________________________________________
Asal Komisariat
: ___________________________________________________________
Jurusan/Semester : ___________________________________________________________ No. HP
: ___________________________________________________________
E-Mail
: ___________________________________________________________
Dengan ini saya mengajukan untuk menjadi peserta Pelatihan Kader Dasar PMII Komisariat Fakultas Ekonomi dan Bisnis masa Khidmat 2018-2019
Foto Foto3X4
3X4
Ciputat,
2018
Yang mengajukan
(................................)
Dzikir, Fikir dan Amal Sholeh
FAKULTAS EKONOMI DAN BISNIS V-03
Jl. Semanggi II Ciputat 15412 Tangerang Selatan Telp. 0822 9868 2414 email: [email protected] Website : www.pmii-komfeis.or.id
Formulir Pendaftaran Nama
: ___________________________________________________________
Tempat/ Tgl Lahir
: ___________________________________________________________
Jenis Kelamin
: ___________________________________________________________
Alamat
: ___________________________________________________________
Asal Komisariat
: ___________________________________________________________
Jurusan/Semester : ___________________________________________________________ No. HP
: ___________________________________________________________
: ___________________________________________________________
Dengan ini saya mengajukan untuk menjadi peserta Pelatihan Kader Dasar PMII Komisariat Fakultas Ekonomi dan Bisnis masa Khidmat 2018-2019
Foto Foto3X4
3X4
Ciputat,
2018
Yang mengajukan
(................................)
Dzikir, Fikir dan Amal Sholeh
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