FORMULIR PELATIHAN KEMENTERIAN PERDAGANGAN DAN PERINDUSTRIAN RI

BIDANG GARMEN
1. Nama Lengkap : ...................................................................................................
2. Tempat, Tgl Lahir : ...................................................................................................
3. Suku / Kebangsaan : ...................................................................................................
4. Agama : ...................................................................................................
5. Pekerjaan : ...................................................................................................
6. Keterampilan diri : ...................................................................................................
7. Pendidikan Terakhir : ...................................................................................................
8. Alamat Sekarang : ...................................................................................................
: ...................................................................................................
9. No. Telp. / HP : ...................................................................................................
10. Status Perkawinan : ...................................................................................................
11. Nama Istri / Suami : ...................................................................................................
12. Jumlah Anak : ...................................................................................................
13. Pekerjaan / Perusahaan : ...................................................................................................
14. Nama Orang Tua / Wali : ...................................................................................................
a. Nama Ayah : ...................................................................................................
b. Nama Ibu : ...................................................................................................
c. Pekerjaan Ayah : ...................................................................................................
d. Pekerjaan Ibu : ...................................................................................................
e. Alamat Orang Tua / Wali : ...................................................................................................
: ...................................................................................................
SINYALEMEN
: ...................................................................................................
a. Berat Badan : ...................................................................................................
b. Tingga Badan : ...................................................................................................
c. Mata : ...................................................................................................
d. Jenis Rambut : ...................................................................................................
e. Warna Kulit : ...................................................................................................
f. Gol. Darah : ...................................................................................................

Dengan ini mengajukan permohonan pelatihan Kementerian Perdagangan dan Perindustrian RI Bidang
Garmen
Lampiran :
Bandung Barat, ......, ..............., 20..
- Photo Copy KTP ( 2 Lembar) Pas Photo Pemohon,
- Photo Copy Ijazah ( 2 Lembar ) 3x4
- Surat Keterangan Sehat
Berwarna
- Surat Ijin Orangtua/suami/istri ( Latar Biru )
- Pas Photo Uk 3x4 = 3 lbr ( ................................................. )
Nama Jelas
(Latar biru)