Biodata Peserta Magang Bumn
Biodata Peserta Magang Bumn
1. Nama : .............................................................................
2. NIM : .............................................................................
3. Tempat, tanggal lahir : .............................................................................
4. Agama : .............................................................................
5. Jenis Kelamin : .............................................................................
6. Prodi : .............................................................................
7. Alamat Rumah
a. Di Bandung (lengkap) : .............................................................................
.............................................................................
8. Alamat Rumah
a. Orang Tua : .............................................................................
.............................................................................
9. Nomor KTP : .............................................................................
10. Alamat e-mail : .............................................................................
11. No. Hp : .............................................................................
12. No. Telp Orang Tua : .............................................................................
13. IPK : .............................................................................
Mengetahui, Bandung,
Prodi Tanda Tangan
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