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FORM STAFFING ANGGOTA BARU

UNIT AKTIVITAS BAND UNIVERSITAS BRAWIJAYA 2014

Nama

: _____________________________________________________________

Nim

: _____________________________________________________________

Fakultas

: _____________________________________________________________

Jurusan

: _____________________________________________________________

Alamat DiMalang

: _____________________________________________________________

Alamat Asal

: _____________________________________________________________

No Telp

: _____________________________________________________________

No Telp Orang Tua

: _____________________________________________________________

Blog UB

: _____________________________________________________________

Instrument Yang Di
Minati

: _____________________________________________________________

Genre

: _____________________________________________________________

Pilihan Divisi
Pilihan 1

: _____________________________________________________________

Alasan

: _____________________________________________________________
_____________________________________________________________

Pilihan 2

: _____________________________________________________________

Alasan

: _____________________________________________________________
_____________________________________________________________

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