SMK NURUL JADID PAITON PROBOLINGGO

THE 4TH STUDENT CREATIVITY FESTIVAL

THROUGHOUT EAST JAVA
TAHUN 2017

FORMULIR PENDAFTARAN PESERTA LOMBA

THE 4TH STUDENT CREATIVITY FESTIVAL (SCF) 2017
THROUGHOUT EAST JAVA
Nomor Registrasi

: ____________________ (diisi panitia)

Nama Lengkap

: ________________________________________________

Tempat Tanggal Lahir

: ________________________________________________

Asal SMP/MTs./Delegasi

: ________________________________________________

Kelas/Tingkat

: ________________________________________________

Alamat Sekolah

: ________________________________________________

Guru Pendamping

: ________________________________________________

Nomor Telp/HP Sekolah/Pendamping

: ________________________________________________
Jenis Lomba

Speed Word Typing

English Speech
English Story Telling
Photography on The Spot
Kreativitas Barang Bekas
Kelengkapan Peserta

Pas Foto 3 x 4 = 2 Lembar

Uang Pendaftaran Rp. 50.000, Foto Copy KTP/Surat Keterangan dari Sekolah/Lembaga

______________, _____________ 2017

PAS FOTO

Peserta,

3 X4

(__________________)
Nama Terang