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PANITIA PEMILIHAN

KETUA RW 06 KALIABANG TENGAH


Sekretariat : KA. Rorotan RT. 11/06 No. 05
Telp : 02188877770, 02195530028, 02194117961

FORMULIR PENDAFTARAN
CALON KETUA RW 06 KALIABANG TENGAH
Nama

: ........................................................................

Tempat, Tanggal Lahir

: ........................................................................

Agama

: ........................................................................

Pekerjaa

: ........................................................................

Status Perkawinan

: ........................................................................

Alamat

: ........................................................................
.........................................................................

Bekasi,

Juni 2013

Pendaftar

Panitia Penerima

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