2. TEMPAT TANGGAL LAHIR : .................... FOTO 3. NISN/NIS : .................... 4. ALAMAT : ........................................................ ........................................................ 5. JABATAN DI KELOMPOK : KETUA 6. KESAN PESAN KEGIATAN : ....................................................................................... .......................................................................................
1. NAMA LENGKAP : ....................
FOTO 2. TEMPAT TANGGAL LAHIR : .................... 3. NISN/NIS : .................... 4. ALAMAT : ........................................................ ........................................................ 5. JABATAN DI KELOMPOK : 6. KESAN PESAN KEGIATAN : ....................................................................................... .......................................................................................
1. NAMA LENGKAP : ....................
2. TEMPAT TANGGAL LAHIR : .................... FOTO 3. NISN/NIS : .................... 4. ALAMAT : ........................................................ ........................................................ 5. JABATAN DI KELOMPOK : KETUA 6. KESAN PESAN KEGIATAN : ....................................................................................... .......................................................................................
1. NAMA LENGKAP : ....................
2. TEMPAT TANGGAL LAHIR : .................... FOTO 3. NISN/NIS : .................... 4. ALAMAT : ........................................................ ........................................................ 5. JABATAN DI KELOMPOK : KETUA 6. KESAN PESAN KEGIATAN : ....................................................................................... .......................................................................................