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FORMULIR PENDAFTARAN FESTIVAL SHOLAWAT AL-BANJARI

SE-KABUPATEN MAGETAN
DALAM RANGKA HARI SANTRI NASIONAL TAHUN 1439 H/2017 M
PENGURUS CABANG NAHDLATUL ‘ULAMA (PCNU) KABUPATEN MAGETAN

NAMA GROUP : .............................................................................................................

UTUSAN DARI : ............................................................................................................. ( * )

ALAMAT : .............................................................................................................

NO. TELEPHON : .............................................................................................................

LAGU BEBAS : 1...........................................................................................................

2...........................................................................................................

NAMA PESERTA :

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Magetan, ....................................... 2017


PIMPINAN GROUP

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CATATAN :
 Diisi dengan huruf kapital
( * ) Diisi kecamatan
Dilampiri FC identitas atau Surat keterangan utusan dari PonPes/Madin

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