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KEMENTERIAN SOSIAL RI

BALAI BESAR PENDIDIKAN DAN PELATIHAN KESEJAHTERAAN SOSIAL


(BBPPKS) REGIONAL II BANDUNG
Jalan Panorama I Lembang-Bandung. Telp. (022) 2786179 Fax. (022)2788904

DIKLAT PERTEMUAN PENINGKATAN KEMAMPUAN KELUARGA


(P2K2)/FAMILY DEVELOPMENT SESSION (FDS) PKH E-LEARNING

BIODATA PESERTA

NO. DATA :

1. NAMA LENGKAP : .......................................................................


2. TEMPAT, TGL LAHIR : .......................................................................

3. JENIS KELAMIN : .......................................................................

4. AGAMA : ........................................................................

5. PENDIDIKAN : ........................................................................

6. JABATAN : ........................................................................

7. UNIT KERJA : ........................................................................

8. ALAMAT UNIT KERJA : .........................................................................


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9. ALAMAT RUMAH : .........................................................................

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TELEPON.........................................................

PAS PHOTO 3 X 4 BANDUNG, 2019

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