Anda di halaman 1dari 1

KEMENTERIAN RISET TEKNOLOGI DAN PENDIDIKAN TINGGI

POLITEKNIK NEGERI MALANG


ELECTRONIC EDUCATION and PROGRAMMING ROBOTIC of MALANG
JalanSoekarnoHatta 9 PO. BOX 04 Malang 65141
Telepon (0341) 404424 - 404425 (pswt 2422) Fax. (0341) 404420
http://www.polinema.ac.id

DAFTAR MAHASISWA PLN 2016/2017

NAMA

KELAS

ALAMAT ASAL

FOTO
4x6

ALAMAT SEKARANG

: ...

TTL

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

ASAL SEKOLAH

NO. HP

HOBI

PRESTASI (AKADEMIK/NON AKADEMIK):


1. ..
2. ..
3. ..
PENGALAMAN ORGANISASI (JIKA ADA ) :
......................................................................................................................................................
......................................................................................................................................................
......................................................................................................................................................
MOTTO: ...............................................
...

TTD

(.)

Anda mungkin juga menyukai