BIODATA

PESERTA WORKSHOP PEMBUATAN BAHAN AJAR
BERBASIS TIK
TAHUN ANGGARAN 2013

1.

Nama

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

2

Tempat/Tanggal Lahir

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

3

Jenis Kelamin

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

4

NIP/NUPTK

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

5

Pangkat/Golongan

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

6

Jabatan

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

7

Alamat

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

8

E-mail

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

9

No. HP

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

10

Unit Kerja

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

11

Alamat Sekolah

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

12

Telpon Sekolah

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

13

E-mail Sekolah

:........................................
Pontianak,
Peserta

September 2013

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