FORMULIR PENDAFTARAN

NOMOR PENDAFTARAN: ______________

1. Nama : _____________________________________________________
2. TTL : _____________________________________________________
3. Telp./HP : _____________________________________________________
4. Kelas : _____ *)Program : ( ) Calistung ( ) SD ( ) SMP___________
5. Asal Sekolah : _____________________________________________________
6. Program Bimbel : ( ) Reguler* ( ) Private*
7. Paket : o Calistung paket A o Bimbel (200.000) o Privat (50.000)*
o Calistung paket B o Bimbel (225.000) o Privat (60.000)*
o Calistung paket C o Bimbel (200.000) o Privat (70.000)*

o SD(1-4) paket A o Bimbel (225.000) o Privat (40.000)*

o SD(1-4) paket B o Bimbel (250.000) o Privat (50.000)*
o SD(1-4) paket C o Bimbel (225.000) o Privat (45.000)*

o SD(5-6) paket A o Bimbel (250.000) o Privat (50.000)*

o SD(5-6) paket B o Bimbel (275.000) o Privat (65.000)*
o SD(5-6) paket C o Bimbel (250.000) o Privat (50.000)*

o SMP(1-2) paket A o Bimbel (300.000) o Privat (60.000)*

o SMP(1-2) paket B o Bimbel (350.000) o Privat (75.000)*
o SMP(1-2) paket C o Bimbel (300.000) o Privat (60.000)*

*lingkari yang dipilih, *)

pembayaran di lakukan pada saat pendaftaran atau paling lambat tanggal 10

PENDAFTAR ADMIN

( ) ( )