FORM CV TA’ARUF

Bismillaahirrahmaanirrahiim
BIODATA LENGKAP

a. Data Diri
Tampak Muka Tampak Samping

1. Nama Lengkap :.................................................................................

2. Nama Panggilan: ................................................................................
3. Tempat, Tgl.Lahir
: ................................................................................
4. Alamat Rumah : ................................................................................
5. Alamat Kantor : ...............................................................................
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6. No. HP : ...............................................................................
7. No. Telp. Rumah : ................................................................................
8. Pekerjaan : .................................................................................
9. Hobi : ................................................................................
10. Suku : ..................................................................................

b. Data Fisik dan Kesehatan

1. Tinggi Badan : .........................................................................
2. Berat Badan : ...........................................................................
3. Golongan Darah : .........................................................................
4. Warna Kulit : ..............................................................................
5. Warna Rambut : ...........................................................................
6. Penyakit yang pernah/ sedang diderita : ............................................
...............................................................................
7. Pengalaman Medis : ..............................................................................

c. Data Pendidikan
No. Jenis Tingkatan Tahun
Pendidikan
1 Formal S3 ............................................................. ................
........ ...
S2 ............................................................. ................
........ ...
S1 ............................................................. ................

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 ........ ...
D3 ............................................................ ................
......... ...
SMA .......................................................... ................
....... ...
SMP .......................................................... ................
........ ...
SD ........................................................... ................
......... ...
2 Informal a. .............................................................. ................
........ ...
b. .............................................................. ................
........ ...
c. .............................................................. ................
........ ...
d. .............................................................. ................
........ ...
e. .............................................................. ................
........ ...

d. Data Lingkungan Kerja

1 Jenis Pekerjaan ( ) PNS ( ) Swasta ( ) Bisnis
( ) ... ... ... ...
2 Nama Perusahaan
3 Bekerja di Bagian
4 Jabatan
5 Tahun Mulai Bekerja
6 Alamat Pekerjaan
7 Jam Kerja
8 Kondisi Keagamaan di tempat Kerja ( ) Baik ( ) Cukup ( ) Kurang
9 Pekerjaan Sampingan

e. Pengalaman Organisasi
No Nama Organisasi Jabatan Tahun
.
1
2
3
4

f. Data Keluarga
Nama Ayah :
...............................................................................................
1. Pekerjaan/ Aktivitas
: ...............................................................................................
2. Usia : .......................................................................................
.........
3. Asal : .......................................................................................
........

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 4. Alamat : .......................................................................................
........
5. Suku : .......................................................................................
...
Nama Ibu :
..........................................................................................
1. Pekerjaan/ Aktivitas
: ..........................................................................................
2. Usia : .......................................................................................
..
3. Asal : .......................................................................................
..
4. Alamat : .......................................................................................
.
5. Suku : .......................................................................................
..
g. Data Saudara
No Nama Usia L/P Status Pekerjaan
. Pernikahan
1
2
3
4

h. Siapa Anda? (Ceritakan)

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i. Tujuan Menikah

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j. Calon Pendamping yang diharapkan
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k. Visi dan Rencana Hidup
Program Jangka Pendek 5 Tahun ke Depan :
1. Peran
Pribadi : .....................................................................................
..............
...................................................................................................
.....................
2. Peran
Keluarga : ..................................................................................
..................
...................................................................................................
.....................
3. Peran
Sosial : .......................................................................................
.......................
...................................................................................................
.....................
4. Peran
Profesi : .....................................................................................
........................
...................................................................................................
.....................
Program Jangka Panjang :
1. Peran
Pribadi : .....................................................................................
.......................
...................................................................................................
......................

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 2. Peran
Keluarga : ..................................................................................
......................
...................................................................................................
.....................
3. Peran
Sosial : .......................................................................................
.......................
...................................................................................................
.....................
4. Peran
Profesi : .....................................................................................
........................
...................................................................................................
.....................

Seluruh Informasi di Atas adalah Benar

Bandung, ... .............................. ..........

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