BERITA ACARA

COACHING BDI 2018

Pada hari ini .................. tanggal ……………………………………….. bulan …………….tahun

.....................................................bertempat di ..............................................,telah
dilaksanakan Kegiatan Coaching yang bertujuan agar KSM dan BKM memahami persyaratan
maupun aturan yang ada pada Kegiatan BDI 2018, yang dihadiri oleh :
Jumlah
No Peserta Yang Hadir Keterangan
(Org)
1 Ketua, Pengurus dan seluruh
Anggota KSM/Panitia
2 Wakil BKM
3 Wakil UPL
4 Relawan
5 Wakil Pemerintah Desa/Kelurahan
6 Tokoh Masyarakat (Tomas)
7 Fasilitator Kelurahan/KMW
8 Dst.... (bila ada)
Daftar Hadir seluruh Peserta Terlampir.

Adapun materi Coaching yang disampaikan adalah mengenai :

.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
 DAFTAR HADIR
Kelurahan :
Kecamatan :
Kota :
Hari/Tanggal :
Tempat : RT. .... RW. .....

No. Nama Alamat Tanda Tangan

1 1

2 2

3 3

4 4

5 5

6 6

7 7

8 8

9 9

10 10

11 11

12 12

13 13

14 14

15 15

16 16

17 17

18 18

Surabaya, …………………2018

Diketahui Oleh, Diperiksa Oleh , Ketua KSM/Panitia

Fasilitator UPL “……………………..”

( ) ( ) ( )
 DOKUMENTASI KEGIATAN
Kelurahan : Sukolilo Baru
Kecamatan : Bulak
Kota : Surabaya
 DOKUMENTASI KEGIATAN
Kelurahan : Kedung Cowek
Kecamatan : Bulak
Kota : Surabaya
 DOKUMENTASI KEGIATAN
Kelurahan : Dupak
Kecamatan : Krembangan
Kota : Surabaya
 DOKUMENTASI KEGIATAN
Kelurahan : Morokrembangan
Kecamatan : Krembangan
Kota : Surabaya
 DOKUMENTASI KEGIATAN
Kelurahan : Kalisari
Kecamatan : Mulyorejo
Kota : Surabaya