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PIK-R WIJAYA KUSUMA

SMA PONDOK MODERN SELAMAT BATANG


MASA BHAKTI 2021/2022

FORMULIR PENDAFTARAN

PESERTA DUTA GENRE TAHUN 2022

 Nama : ..............................................................................................

 TTL : .............................................................................................

 Alamat : ..............................................................................................

 Hobi : ..............................................................................................

 Umur :..............................................................................................

 Cita-cita :...............................................................................................

 Pengalaman :................................................................................................

 Bakat :................................................................................................

 Minat :...............................................................................................

 Motivasi Ikut Duta Genre : .........................................................................

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