PANITIA PELAKSANA

MASA PENERIMAAN ANGGOTA BARU ( MAPABA )

KOMUNITAS MAHASISWA NGGUSU WARU ( KMNU )
BaseCamp :Jl.Pelita No. Lingk. Salama ( Kompleks Radio Dompu Fm )Kel.Bada Dompu
Email ( Kmnu@yahoo.Co.Id / komunitasmahasiswangguswaru.blgspot.com.) kode pos. 84211
Formulir Pernyataan: No. :

Yang bertanda tangan dibawah ini :

Nama
: ..............................................................................................................
Alamat
: ..............................................................................................................
TTL
: ..............................................................................................................
Pekerjaan
: ..............................................................................................................
Hobby
: ..............................................................................................................
Tlp / HP
: ..............................................................................................................
Asal Perguruan Tinggi
: ..............................................................................................................
Pengalaman Beroganisai :
SMP
1. ............................................................................................................................................................
2. ............................................................................................................................................................
3. ............................................................................................................................................................
SMA
1. ............................................................................................................................................................
2. ............................................................................................................................................................
LAIN LAIN
1. ............................................................................................................................................................
2. ............................................................................................................................................................
Menyatakan siap untuk mengikuti Masa Penerimaan Anggota Baru ( MAPABA )
Komunitas Mahasiswa Nggusu Waru ( KMNU )
Peserta
PAS
PHOTO

................................................................................................................................................................

PANITIA PELAKSANA
MASA PENERIMAAN ANGGOTA BARU ( MAPABA )
KOMUNITAS MAHASISWA NGGUSU WARU ( KMNU )
BaseCamp :Jl.Pelita No. Lingk. Salama ( Kompleks Radio Dompu Fm )Kel.Bada Dompu
Email ( Kmnu@yahoo.Co.Id / komunitasmahasiswangguswaru.blgspot.com.) kode pos. 84211
Formulir Pernyataan: No. :

Yang bertanda tangan dibawah ini :

Nama
: ..............................................................................................................
Alamat
: ..............................................................................................................
TTL
: ..............................................................................................................
Pekerjaan
: ..............................................................................................................
Hobby
: ......................... ....................................................................................
Tlp / HP
: ..............................................................................................................
Asal Perguruan Tinggi
: ..............................................................................................................
Pengalaman Beroganisai :
SMP
1. ............................................................................................................................................................
2. ............................................................................................................................................................
3. ............................................................................................................................................................
SMA
1. ............................................................................................................................................................
2. ............................................................................................................................................................
LAIN LAIN
1. ............................................................................................................................................................
2. ............................................................................................................................................................
Menyatakan siap untuk mengikuti Masa Penerimaan Anggota Baru ( MAPABA )
Komunitas Mahasiswa Nggusu Waru ( KMNU )
Peserta
PAS
PHOTO

Visi KMNU :
Mewujudkan Dompu Yang Lebih Baik Dengan Membangun Masyarakat Sipil
Yang Kuat.
Mahasiswa Yang Berkualitas Dan Mendorong Pemerintah Yang Demokratis
berbasis Nilai- nilai Nggusu waru.
Misi KMNU :
Membangun Masyararakat Yang Kuat, Sadar Akan Hak- haknya
Menciptakan Mahasiswa Sebagai Agent Of Change & Agent Control,
Mendampingi Masyarakat Miskin, Mengawasi Kebijakan Pemerintah Yang
Pro Masyarakat Miskin.
Mendorong Pemerintah Yang Demokratis, Adil, Jujur, Transparan
& Kesetaraan.