NO:

IKATAN Remaja Ceria Jakarta Timur

Sekretariat Remaja Ceria Jakarta Timur
Jl. Otto Iskandar Dinata no. 121
Jakarta Timur, 13330
No. Telp: 021-41307454; Email: rcjaktim@yahoo.com

FORMULIR PENDAFTARAN
Pemilihan Remaja Ceria Jakarta Timur 2013

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

Tempat/Tanggal lahir :..................................................................................................................................
Suku Bangsa :..................................................................................................................................
Pekerjaan :..................................................................................................................................
Alamat :..................................................................................................................................
Tinggi Badan :................................................ // Berat Badan:.......................................................
Alamat Rumah :..................................................................................................................................
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Kec :...................................................... Kodya : ....................................................
No. Telepon : ................................................................ HP : ........................................................
Nama /Pekerjaan Orang Tua : (Ayah)................................................................/.....................................................
(Ibu)................................................................../......................................................
Sekolah/Kampus : ........................................................... Kelas/Jurusan : ............................................
Keterampilan Bahasa Asing : .................................................................................................................................
Prestasi Akademik : 1. .............................................................................................................................
2. .............................................................................................................................
3. .............................................................................................................................

Prestasi Non Akademik : 1. .............................................................................................................................

2. .............................................................................................................................
3. .............................................................................................................................

Jakarta, .................................. 2013

Penerima OrangTua/Guru/Wali Pendaftar

(......................................) (...........................................) (................................................)

Pengembalian Formulir :
Mulai 1 April s.d. 26 April 2013 Kelengkapan Audisi:
Setiap Kamis, Jumat, Sabtu 1. Foto berwarna ukuran 3x4 (5 lembar)
di Ruang Sekretariat RCJT
GRJT Otista, Jakarta Timur (pkl. 13.00 – 18.00) 2. Foto (studio) Close Up ukuran 4R (3 lembar)
Technical Meeting & Batas Pengembalian Formulir 3. Foto (studio) Seluruh Badan 4R (2 lembar)
Tanggal: Jum’at, 26 April 2013 4. Fotokopi KTP/KTM/Kartu pelajar (2 lembar)
Waktu: pkl. 15.00 s.d. Selesai 5. Surat Izin Mengikuti Pemilihan Remaja CERIA
Tempat: Auditorium GRJT, Otista 6. CV (Curriculum Vitae)
Audisi: 7. Dimasukkan ke dalam Map Merah (Putri), Biru (Putra)
Tanggal: Sabtu, 27 April 2013 dan DIBERI NAMA LENGKAP.
Waktu: pkl. 08.00 s.d. Selesai
Tempat: Auditorium GRJT, Otista
Information Center
CP : (021) 41307454 (calls only); 085213876655
Email & YM : rcjaktim@yahoo.com
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