UNIVERSITAS INDRAPRASTA PGRI

BADAN EKSEKUTIF MAHASISWA

UNIT KEGIATAN MAHASISWA
KELUARGA MAHASISWA KATOLIK
Jl. Nangka Nomor 58 C, Tanjung Barat, Jagakarsa, Jakarta Selatan, 12530
Telepon : (021) 78835283, 7818718. Email : kmkunindra@gmail.com

DATA MAHASISWA KATOLIK

UNIVERSITAS INDRAPRASTA PGRI

FAKULTAS : .................... JURUSAN : ................................ TH. MASUK : ..................

NPM : ............................................
NAMA LENGKAP ..................................................................................................................
TEMPAT/TGL LAHIR : ...........................................................................................................
ASAL SEKOLAH : ..................................................................................................................
ALAMAT RUMAH : ...............................................................................................................
TELP/ HP : ............................................ EMAIL : ..................................................................
INSTAGRAM : ................................ FACEBOOK : .......................... TWITTER : ......................
NAMA AYAH : .....................................................................................................................
PEKERJAAN : ..................................................... AGAMA : ..................................................
NAMA IBU : .........................................................................................................................
PEKERJAAN : ..................................................... AGAMA : ...................................................
ALAMAT ORANGTUA : .........................................................................................................
KOTA/KABUPATEN : ..................................... PROVINSI : ....................................................
PAROKI ASAL : .............................................. KEUSKUPAN : ................................................

1. APAKAH ANDA MENDAPAT PENDIDIKAN IMAN KATOLIK DI KELUARGA ?

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2. APAKAH YANG MENJADI CITA-CITA ANDA ?
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3. MENGAPA ANDA MENJADI KATOLIK / TETAP INGIN MENJADI KATOLIK ?
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