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FORMULIR PEMINJAMAN KREDIT LAPTOP

KOMUNITAS MAHASISWA BIDIKMISI


UNIVERSITAS SEBELAS MARET SURAKARTA
Nama lengkap

: .

NIM

: .

Pas foto

Prodi/Jurusan

: .

3x4

Fakultas

: .

Semester

: .

Alamat kost

: .
.

Alamat asal

: .
.

No. HP

: .

Email

: .

Orang tua/wali
Nama

: .

Alamat

: .

No. HP

: .

Tipe Laptop/netbook

: .

JangkaWaktuPengangsuran

: .

Harga*

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

Penghasilan orang tua

: .........................................................................................................
Surakarta, 2015
Pendaftar

(.)

*diisi oleh pengurus Komadiksi SMART UNS

Alasan mengikuti Kredit laptop :


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