BIODATA PRIBADI

I. KETERANGAN PRIBADI :
Nama :
NIP :
Tempat & Tanggal Lahir :
Agama :
Pangkat/ Gol. Ruang :
Alamat Rumah :
Alamat Kantor :
Telpon :
Jabatan :

II. RIWAYAT PENDIDIKAN :

SD/MI :
SMP/MTs :
SMA/MA :
S.1 : S1 Pendidikan Agama, Fak. ........................ Tahun ..................... (........................)
S.2 : S2 Magister ...................................................... Tahun .............. (........................)

III. RIWAYAT PEKERJAAN/ :

KEPANGKATAN
1. Calon Pegawai Negeri Sipil (CPNS) TMT ....................... Gol. Ruang (..................)
2. Pegawai Negeri Sipil (PNS) TMT ........................
3. .....................................................................................
4. .............................................................................................
5. .............................................................................................
6. .............................................................................................

IV. RIWAYAT JABATAN :

1. ...........................................................................................................................................................................................................
2. ........................................................................................................................................................................................
3. ............................................................................................................................................................................................................
4. .........................................................................................................................................................................................
5. ........................................................................................................................................................................................
6. ........................................................................................................................................................................................
7. .........................................................................................................................................................................................

V. RIWAYAT PELATIHAN :
1. Diklat Prajabatan Gol. .............Tahun ....................
2. ..............................................................................................
3. ...............................................................................................
4. ...............................................................................................
5. ...............................................................................................
6. ..............................................................................................
7. ...............................................................................................
8. ...............................................................................................
VI. PENGALAMAN ORGANISASI :
1. ......................................... :
2. ......................................... :
3. ......................................... :

VII. PENGALAMAN LUAR NEGERI :

1. ...................................... :
2. ..................................... :
3. ...................................... :

VIII.TANDA PENGHARGAAN :
1. ...................................... :
2. ...................................... :
3. ...................................... :

IX. KETERANGAN KELUARGA :

1. Nama Ayah Kandung : ...............................................
2. Nama Ibu Kandung : ...............................................
3. Nama Suami/Istri : .................................................
4. Nama Anak :
1. .......................................................
2. .......................................................
3. ........................................................
5. Jumlah Saudara : ............. Orang

Demikian Biodata Pribadi ini saya buat dengan sebenarnya untuk dipergunakan sebagaimana
perlunya.

Wassalam,
Palu, .......................... 2016

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