FORMULIR PENDAFTARAN ANGGOTA FORUM GENRE KUTAI BARAT

2022/2023
BIODATA
Nama Lengkap : ________________________________________________

Kelas : ________________________________________________

Tempat, Tanggal Lahir : ________________________________________________

Asal PIK-R : ________________________________________________

Alamat Rumah : ________________________________________________

Nomor Telp/Hp : ________________________________________________

PENGALAMAN ORGANISASI : ________________________________________________

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PRESTASI

**AKADEMIK : ________________________________________________

**NON AKADEMIK : ________________________________________________

ORGANISASI YANG DIIKUTI

*di sekolah : ________________________________________________

*di luar sekolah : ________________________________________________

Hobi : ________________________________________________

Motivasi bergabung di Forum : ________________________________________________

GenRe

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