UNIT KEGIATAN MAHASISWA

PERSATUAN OLAHRAGA MAHASISWA

(UKM PORMA)
UNIVERSITAS MATHLA’UL ANWAR BANTEN
Jl. Raya Labuan KM.2. Saketi – pandeglang , Telp +62 859-3037-6698

DAFTAR PEMAIN

NAMA SEKOLAH ..........................................................

CABANG OLAGRAGA …………………………………………
PEMAIN

Nama Kapten : .............................................................

3 X 4
Tanggal Lahir : .............................................................
1 No.Punggung : .............................................................
No.Telp : ..............................................................

Naman : ..............................................................
3 X 4 Tanggal Lahir : ..............................................................
2 No.Punggung : ..............................................................
No.Tlp : ..............................................................

Naman : ..............................................................
3 X 4 Tanggal Lahir : ..............................................................
3 No.Punggung : ..............................................................
No.Tlp : ..............................................................

Naman : ..............................................................
3 X 4 Tanggal Lahir : ..............................................................
4 No.Punggung : ..............................................................
No.Tlp : ..............................................................

Naman : ..............................................................
3 X 4 Tanggal Lahir : ..............................................................
5 No.Punggung : ..............................................................
No.Tlp : ..............................................................
 UNIT KEGIATAN MAHASISWA
PERSATUAN OLAHRAGA MAHASISWA
(UKM PORMA)
UNIVERSITAS MATHLA’UL ANWAR BANTEN
Jl. Raya Labuan KM.2. Saketi – pandeglang , Telp +62 859-3037-6698

Naman : ..............................................................
3 X 4 Tanggal Lahir : ..............................................................
6 No.Punggung : ..............................................................
No.Tlp : ..............................................................

Nama : .............................................................
3 X 4 Tanggal Lahir : .............................................................
7 No.Punggung : .............................................................
No.Telp : ..............................................................

Naman : ..............................................................
3 X 4 Tanggal Lahir : ..............................................................
8 No.Punggung : ..............................................................
No.Tlp : ..............................................................

Naman : ..............................................................
3 X 4 Tanggal Lahir : ..............................................................
9 No.Punggung : ..............................................................
No.Tlp : ..............................................................

Naman : ..............................................................
3 X 4 Tanggal Lahir : ..............................................................
10 No.Punggung : ..............................................................
No.Tlp : ..............................................................

Naman : ..............................................................
3 X 4 Tanggal Lahir : ..............................................................
11 No.Punggung : ..............................................................
No.Tlp : ..............................................................
 UNIT KEGIATAN MAHASISWA
PERSATUAN OLAHRAGA MAHASISWA
(UKM PORMA)
UNIVERSITAS MATHLA’UL ANWAR BANTEN
Jl. Raya Labuan KM.2. Saketi – pandeglang , Telp +62 859-3037-6698

Naman : ..............................................................
3 X 4 Tanggal Lahir : ..............................................................
12 No.Punggung : ..............................................................
No.Tlp : ..............................................................

OFFICIAL
1

3 X 4 Naman : ..............................................................
Tanggal Lahir : ..............................................................
No.Tlp : ..............................................................

Naman : ..............................................................
3 X 4
Tanggal Lahir : ..............................................................
No.Tlp : ..............................................................