PANITIA PELATIHAN KEPEMIMPINAN DASAR (PKD)

PIMPINAN ANAK CABANG GERAKAN PEMUDA ANSOR

KECAMATAN SAMPANG KABUPATEN CILACAP
Sekretariat: Jl. Masjid No. 03 Karangjati Kec. Sampang Kab. Cilacap Hp: 085227619199

FORMULIR PENDAFTARAN
PELATIHAN KEPEMIMPINAN DASAR (PKD)
PAC GERAKAN PEMUDA ANSOR KECAMATAN SAMPANG

Saya yang bertandatangan di bawah ini:

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Riwayat Pelatihan : .......................................................................................................
Ukuran Baju :S M L XL XXL

Mohon di daftar sebagai peserta PENDIDIKAN KEPEMIMPINAN DASAR (PKD) yang

di selenggarakan oleh PAC GP ANSOR Kecamatan Sampang pada tanggal 28
Februari s.d 1 Maret 2020.
Demikian atas perhatiannya disampaikan terimakasih.

………………………., ….... Februari 2020

Pas Foto Hormat saya,

4x6

(………………………..………)

PKD PAC GP Ansor Kec. Sampang 2020

 PANITIA PELATIHAN KEPEMIMPINAN DASAR (PKD)
PIMPINAN ANAK CABANG GERAKAN PEMUDA ANSOR
KECAMATAN SAMPANG KABUPATEN CILACAP
Sekretariat: Jl. Masjid No. 03 Karangjati Kec. Sampang Kab. Cilacap Hp: 085227619199

PKD PAC GP Ansor Kec. Sampang 2020