KEMENTERIAN RISET, TEKNOLOGI, DAN PENDIDIKAN TINGGI

UNIVERSITAS SILIWANGI
FAKULTAS KEGURUAN DAN ILMU PENDIDIKAN
HIMPUNAN MAHASISWA JURUSAN PENDIDIKAN EKONOMI
Sekretariat : Gedung ORMAWA FKIP – HMJ DIKMI
Jalan Siliwangi No. 24 Kotak Pos 164 Tasikmalaya 46115 Email: hmjdikmiunsil@gmail.com

FORMULIR PENDAFTARAN
CALON PENGURUS HMJ DIKMI 2020

Informasi Pribadi

Nama Lengkap : .....................................................................

NPM : .....................................................................

Tempat & Tanggal Lahir : ......................................................................

Agama : .....................................................................

Riwayat Pendidikan : .....................................................................

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3X4
No.Telp/Hp : .....................................................................

Alamat E-mail : .....................................................................

Kemampuan-Keahlian
Alamat Asal : .....................................................................

Alamat Saat Ini : .....................................................................

Public Speaking
Hobby : .....................................................................
Design Grafis (Photo Shop,
UKM/ Organisasi Yang : ...................................................................... Corell Draw,dll)
Sedang Diikuti
Iptek
Pengalaman Organisasi (5 Tahun Terakhir)
Tulis-Menulis

Ada Tidak Ada Talent (Music,Dance)

(Jika Ada) Banjari,Qiro’ah

1 .............................................. sebagai................................................... Lainnya

2 .............................................. sebagai................................................... ........ ..........................

3 .............................................. sebagai...................................................
Motto Hidup
Prestasi Yang Pernah Diraih (5 Tahun Terakhir)
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1 .............................................................................................
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2 .............................................................................................
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3 .............................................................................................
 KEMENTERIAN RISET, TEKNOLOGI, DAN PENDIDIKAN TINGGI
UNIVERSITAS SILIWANGI
FAKULTAS KEGURUAN DAN ILMU PENDIDIKAN
HIMPUNAN MAHASISWA JURUSAN PENDIDIKAN EKONOMI
Sekretariat : Gedung ORMAWA FKIP – HMJ DIKMI
Jalan Siliwangi No. 24 Kotak Pos 164 Tasikmalaya 46115 Email: hmjdikmiunsil@gmail.com

Divisi Yang Diminati (Pilih 2 Divisi)

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Program Kerja Yang Diminati

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Motivasi Anda Ingin Bergabung Di Himpunan Mahasiswa Jurusan Pendidikan Ekonomi

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Demikian formulir pendaftaran ini saya isi dengan sebenar-benarnya dengan penuh rasa tanggung
jawab dan siap menanggung segala resiko. Dengan ini saya mendaftarkan diri untuk menjadi bagian
dari keluarga besar Himpunan Mahasiswa Jurusan Pendidikan Ekonomi 2020.

Tasikmalaya, ...........................2020

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