ApplicantInformation

NamaLengkap

Tempatdan
TanggalLahir
JenisKelamin

YoyokSantoso,S.pd

GunungBatu,05September1992

Agama

Islam

Alamat
NomorKontak

Jl.RawaJayaIINo.327RT.006RW.002Kel.PahlawanDekat
KampusIAINPalembangSumateraSelatanKodePos:30127
082111446394dan081367128362

Email

yoyokpenjas@yahoo.com

Lakilaki

MaritaStatus
/Status
Pernikahan

Single

Mariied

Widower

PhysicalInformation/InformasiFisik
Height(Cm)

174

Weight(Kgs)

81

ID&Licenses(Number,Validity,PlaceofIssue)/Tanda
Pengenal(nomor,masaberlaku,tempatpembuatan)

Bloodtype

IDorPassportNo.

3216060509920012

DriverslicenseType&
No.

SIMC

Kontakdalamkeadaandarurat(alamatlengkap,Telp/HP/Email//Hubungandengananda)

Jl.RawaJayaIINo.327RT.006RW.002Kel.Pahlawan,085267484389(MyUnclesHome)

FamilyData
M/ Agen
F
/Umur

Relationship

Name/Nama

Education/Pendidikan

Current
Occupation/
Activities/
Pekerjaansaat
ini

Remarks/
Keterangan

Father/Ayah

Ismail

52

SMP

Wiraswasta

Mother/Ibu

Bulan,S.Pd

56

Strata1

GuruSD

Brother/sister1/ Yoyok
saudara
Santoso,S.Pd

22

Strata1

BelumBekerja

Brother/sister2/ CandraSugiarto
saudara

20

SMA

Mahasiswa

Brother/sister3/ HeriTriyono
saudara

18

SMA

Mahasiswa

LastFormalEducation

Level

School/Sekolah

Major/
Jurusan

Year(frTo)
Location/lokasi
Tahun

University/
Academy

Unisma45Bekasi
Timur/S1

Penjaskesrek

2009

Certificate
Score/GPA/nilai
ahir

Bekasi

3,47scaleof4

TrainingRecords/RiwayatKursus/Pelatihan
Topics/TemaPelatihan

Facilitator/Provider/Penyelenggara

Location/Tempat

Duration/
Lama(Hrs)

Year/
Tahun

PerwasitanBasketBall

Unisma45"BekasiTimur

BekasiTimur

2hari

2009

CoachingClinicFutsal

GORBekasiTimur

BekasiTimur

3hari

2011

Ospek/Madabintal(Masa
DasarPembinaanFisikdan
Mental)

Unisma45BekasiTimurby
SeniorUnisma45

BekasiTimur

4hari

2009

PemantapanKedisiplinan
Mahasiswa

Unisma45BekasiTimurby
SeniordanStafDosenUnisma
45

Bogor

2hari

2010

LanguagesMastering/Penguasa
UDERSTANDING

Languages/Bahasa

Indonesia
9
English

READING
G

CONVERSATION
P

G
9

WRITING

9
9

Oganization/SocialActivities/AktifitasSosial
Oganization/Organisasi

ScopeofActivities

YourRole/Fuction/
Fungsianda

Praticipationperiod
(Mo/Yr)/Waktu

HIMOR

HimpunanMahasiswa
Olahraga

Anggota

20102011

KarangTaruna

Kegiatananakanak
muda

Ketua

20122014

Menanyakan
nAndaSeca
araLengkap
Refferencess/ReperensiJikaPerussahanInginM
Nam
me(1)

Bullan,S.pd
Nam
me(2)

Jem
madilF
Nam
me(3)

Sup
parmanS,,S.Pd,M.O
Or

Occup
pation/Profeession

Relationship
R
pwithyou

TEACHER

MyMo
other

Occup
pation/Profeession

Relationship
R
pwithyou

PUB
BLICWOR
RKS

MyUn
ncle

Occup
pation/Profeession

Relationship
R
pwithyou

TEACHER

MyTeaacher

Address//Phone/HP//Email

085839
9030150
Address//Phone/HP//Email

085267
7484389
Address//Phone/HP//Email

081355
5658181

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mempertang

mbang,

Palem

YOYOKSANTOSOS.Pd
Fulln
name&signature/namaalengkap&tandatangan