BIODATA ………………

PAC/PR/PAR PDI PERJUANGAN

KOTA ...........................................................
( MASA BAKTI 2019 – 2024 )
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FORMAT BIODATA SILAHKAN
DISESUAIKAN DENGAN KEBUTUHAN
1. Nama Lengkap : ..............................................................................................
2. Struktural 2019-2024
Jabatan : ..............................................................................................
DPC Kab/ Kota : ..............................................................................................
3. Alamat Rumah : ..............................................................................................
..............................................................................................
..............................................................................................
4. Nomor Telp :
a. Rumah : 0.......... - ...................................../ 0........, ............................
b. Kantor : 0.......... - ...................................../ 0........, ............................
c. Hanphone : 0.......... - ...................................../ 0........, ............................

5. Tempat/Tgl. Lahir : ............................../ ......... - .............................. - .................

6. Agama : ..............................................................................................
7. Status : belum menikah / menikah / pernah menikah *
8. Jenis Kelamin : laki-laki / perempuan *
9. Jabatan lainnya saat ini :
A. LEGISLATIF
Tingkat : RI / Provinsi / kabupaten / Kota *
Jabatan di Komisi : Ketua / Wakil Ketua / Anggota *
Jabatan di Fraksi : Ketua / Wakil Ketua / Sekretaris / Bendahara / Anggota *

B. EKSEKUTIF
Tingkat : Provinsi / Kabupaten / Kota *
Jabatan : Gubernur / Wakil Gubernur *
Bupati / Wakil Bupati / Walikota / Wakil Walikota *
Tmp/ Tgl Pelantikan : ..................................../ ............ - ..................... - ................
No. Surat Kepres : ..............................................................................................

10. Riwayat Pendidikan

A. PENDIDIKAN FORMAL
Strata Pendidikan Tinggi : S1 / S2 / S3 / Profesor *
Jurusan / Kebidangan : ....................................................................................

Tingkat Nama Sekolah / Perguruan Tinggi Periode (tahun) Keterangan

SD Lulus/ tidak *

SMP Lulus/ tidak *

SMA Lulus/ tidak *

Lulus/ tidak *

Lulus/ tidak *
 B. PENDIDIKAN NON FORMAL
- .................................................................................................................................
- .................................................................................................................................
- .................................................................................................................................
- .................................................................................................................................
- .................................................................................................................................
- .................................................................................................................................
11. Riwayat Pekerjaan :

Nama Perusahaan Periode Kerja (tahun) Jabatan terakhir

12. Riwayat Keanggotaan Partai

a. Pernah menjadi anggota Partai lain selain PDI Perjuangan :

Nama Partai Periode Keanggotaan (tahun)

b. Nomor KTA PDI Perjuangan : .........................................................................

c. Lama Keanggotaan PDI Perjuangan : ............ Tahun

13. Penugasan Partai di Lembaga Formal

- .................................................................................................................................
- .................................................................................................................................
- .................................................................................................................................
14. Pendidikan/ Pelatihan Partai
- .................................................................................................................................
- .................................................................................................................................
- .................................................................................................................................
- .................................................................................................................................
15. Kegiatan Insidential yang ditugaskan Partai
- .................................................................................................................................
- .................................................................................................................................
- .................................................................................................................................
- .................................................................................................................................
16. Prestasi terbesar untuk Partai
- .................................................................................................................................
- .................................................................................................................................
- .................................................................................................................................
 - .................................................................................................................................
17. Loyalitas / Pengorbanan untuk Partai
- .................................................................................................................................
- .................................................................................................................................
- .................................................................................................................................
- .................................................................................................................................
18. Presepsi Positif Publik yang pernah dimuat di Media Massa
- .................................................................................................................................
- .................................................................................................................................
- .................................................................................................................................
- .................................................................................................................................
19. Lain-lain yang dipandang perlu
- .................................................................................................................................
- .................................................................................................................................
- .................................................................................................................................
- .................................................................................................................................
- .................................................................................................................................
20. Faktor-faktor Netral
a. Aktifitas dalam Organisasi Kemanusiaan :
- .................................................................................................................................
- .................................................................................................................................
b. Aktifitas dalam Organisasi Sosial :
- .................................................................................................................................
- .................................................................................................................................
c. Aktifitas dalam Ormas :
- .................................................................................................................................
- .................................................................................................................................
d. Aktifitas dalam Organisasi Profesi :
- .................................................................................................................................
- .................................................................................................................................
e. Aktifitas lain yang dianggap perlu :
- .................................................................................................................................
- .................................................................................................................................
21. Faktor – Faktor Negatif
a. Pelanggaran Hukum – Hukum Negara
- .................................................................................................................................
- .................................................................................................................................
b. Penyelewengan Kewenangan Partai
- .................................................................................................................................
- .................................................................................................................................
c. Penyelewengan Asset/ keuangan Partai
- .................................................................................................................................
 - .................................................................................................................................
d. Terlibat Politik Uang
- .................................................................................................................................
- .................................................................................................................................
e. Persepsi Positif publik yang pernah dimuat di media massa
- .................................................................................................................................
- .................................................................................................................................
f. Persepsi Negatif Publik yang pernah dimuat di media massa
- .................................................................................................................................
- .................................................................................................................................

Demikian Biodata ini saya buat dengan sesungguhnya, bila ternyata dikemudian hari ada penyimpangan, saya

bersedia diberikan sanksi organisasi sesuai ketentuan Partai yang berlaku.

........................., ......................., 20....

Yang Membuat,

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