SEKSI MAHASISWA IKATAN AHLI GEOLOGI INDONESIA

SEKOLAH TINGGI TEKNOLOGI MINYAK DAN GAS BUMI

(SM-IAGI STT MIGAS)
Sekretariat: Kampus I STT Migas Balikpapan
Jalan Soekarno Hatta Km. 8
Balikpapan, Kalimantan Timur 76113
Email: smiagisttmigas@gmail.com

FORMULIR PENDAFTARAN
INTERNATIONAL GEOMAPPING 2015
NAMA

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JENIS KELAMIN : ...............................................................................................

TTL

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ALAMAT

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NO. TELEPON

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Alasan mengapa saya harus terpilih menjadi perwakilan tim dari STT Migas
Balikpapan untuk mengikuti International Geomapping:
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