P. 1
formulir

formulir

|Views: 6|Likes:
Dipublikasikan oleh Rere Reza Rindani

More info:

Published by: Rere Reza Rindani on May 05, 2013
Hak Cipta:Attribution Non-commercial

Availability:

Read on Scribd mobile: iPhone, iPad and Android.
download as DOC, PDF, TXT or read online from Scribd
See more
See less

03/29/2014

pdf

text

original

PANITIA LOMBA BIRDWATCHING

TAHURA R. SOERJO
DINAS KEHUTANAN PROVINSI JAWA TIMUR
2012
Sekretariat : KANTOR DINAS KEHUTANAN
Jl. Bandara Juanda SURABAYA 612!
Tel". #!1$%666&'( )a*. %66+%%
E$,ail : -ird.at/0in1ta0uradi20ut3ati,45a066./6,
FORMULIR PENDAFTARAN
7ertan5aan$"ertan5aan di -a.a0 /uku" dii2i 6le0 2atu "er.akilan an116ta ti,
Na,a Ti, 8 .........................................................................................................................
Na,a An116ta Tea, 1. ........................................................................... Ttl : ...................................
2. ........................................................................... Ttl : ..................................
!. ........................................................................... Ttl : ..................................
A2al In2tan2i ..........................................................................................................................
Ala,at E$,ail ..........................................................................................................................
N6. Tel" 9 H7 8 ..........................................................................................................................
PERTANYAAN 8:
1. Bera"a 3u,la0 /0e/kli2t -urun1 5an1 2uda0 "erna0 anda te,ui ;
2. Se-utkan 1# 3eni2 -urun1 dari /0e/kli2t anda 5an1 ter,a2uk -urun1 dilindun1i -erda2arkan
"erundan1$undan1anan Re"u-lik Ind6ne2ia atau IU<N dan di,ana anda ,eli0atn5a =
!. >6ka2i$l6ka2i ,ana 2a3a 5an1 "erna0 anda kun3un1i dala, "en1a,atan -urun1 2ela,a ini ;
&. Se-utkan ,ak2i,al ! "en1ala,an anda dala, dunia k6n2er?a2i( 6rnit06l615 atau ek6.i2ata =
. A"aka0 anda "un5a -l61 "ri-adi( ,edia k6,unita2( akun @a/e-66k( atau t.itter ; Jika "un5a
tuli2akan na,a ,edia atau akun ter2e-ut =
6. Jika anda ter"ili0 untuk ,en1ikuti >6,-a Bird Aat/0in1 Ta0ura( -er2ediakan anda -er-a1i
"en1ala,an anda ,elalui ,edia$,edia di ata2 ;
+. Dari ,anaka0 anda ,enda"atkan in@6r,a2i "alin1 -e2ar tentan1 Tahua R. S!"#! $
%. Dari ,anaka0 anda ,enda"atkan in@6r,a2i tentan1 L!%&a B'( Wa)*h'+, Tahua R. S!"#!
D'+a- K"hu)a+a+ P!.'+-' Ja/a T'%u 2012 '+' $
In@6 le-i0 lan3ut di e$,ail : -ird.at/0in1ta0uradi20ut3ati,45a066./6, 9
....di20ut.3ati,"r6?.16.id 9 -ird.at/0in1/an1ar..6rd"re22./6,

You're Reading a Free Preview

Mengunduh
scribd
/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->