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KOMUNITAS MOTOR BOX INDONESIA

(KOMBO)
WILAYAH ACEH
SEKRETARIATAN: JL. ISKANDAR MUDA CAFEE BANGKOTAN ULHEE LHEUE, KOTA BANDA ACEH. TELP:
082398828426

BIODATA DIRI
Komunitas Motor Box Indonesia - Aceh
Nama Lengkap : ...........................................................................................................
Nama Panggilan : ...........................................................................................................
Tempat, Tgl. Lahir : ...........................................................................................................
Jenis kelamin : ...........................................................................................................
Agama : ...........................................................................................................
Alamat : ...........................................................................................................
Asal Club : ...........................................................................................................
E-mail : ...........................................................................................................
Facebook : ...........................................................................................................
Instagram : ...........................................................................................................
No. Plat : ...........................................................................................................
No. WhatsApp : ...........................................................................................................
Dengan mengisi biodata ini, saya siap bergabung dengan penuh rasa solidaritas,
kekompakan, dan kebersamaan keluarga KOMBO Aceh. Terima Kasih.

Aceh, ...............................2017

Salam Semok

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KOMBONESIA

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