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FORMULIR CALON ANGGOTA PASKIBRA

SMAN 2 PRINGSEWU

Nama Lengkap
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Nama Panggilan
: ............................................................................................................................
Nomor
Handphone
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Kelas
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: .............................................................................................................

Jenis Kelamin
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Tempat/Tgl Lahir
: ............................................................................................................................
Alamat Lengkap
: ............................................................................................................................
Orang Tua/Wali
: ............................................................................................................................
Agama
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: ...................................................................................................

Motivasi Mengikuti
Ekstrakulikuler Paskibra
: ............................................................................................................................
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Tinggi Badan
: ...........................................................................................................................
Berat Badan
: ...........................................................................................................................

Pringsewu,

Juli 2014

FORMULIR CALON ANGGOTA PASKIBRA


SMAN 2 PRINGSEWU
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NB* Formulir dapat diperbanyak sesuai kebutuhan

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