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FORMULIR CALON MITRA RUMAH TAHFIDZ

Bismillaahirahmaanirrohiim

LEMBAGA
Nama : .............................................................................................
Alamat :..............................................................................................
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Telp/HP :.....................................................Hp....................................
Email :..............................................................................................
Penanggungjawab :..............................................................................................
Badan hukum :..............................................................................................
Jenis Kegiatan :..............................................................................................
Jumlah donatur :..............................................................................................

PERORANGAN
Nama Lengka p :..............................................................................................
TTL :.............................................................................................
Jenis Kelamin :L / P*
Pekerjaan : .............................................................................................
Alamat : .............................................................................................
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Telepon / HP : ............................................................................................
Pendidikan : ............................................................................................
Menyatakan dengan ini bersedia menjadi mitra Rumah Tahfidz PPPA Daarul
Quran dan bersedia mengikuti ketentuan serta aturan yang telah dibuat

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