KECAMATAN GALESONG SELATAN PERIODE 2021-2026 Sekretariat : Jl. Poros Galesong Selatan, Desa Bontokassi, Telp/WA : 085340244361
FORMULIR PENDAFTARAN CALON PESERTA LATIHAN KADER 1 ANGKATAN 1 KARANG TARUNA INDONESIA KECAMATAN GALESONG SELATAN
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Nama Panggilan :..................................................................................................... Tempat Tgl. Lahir :..................................................................................................... Agama : .................................................................................................... Jenis Kelamin : .................................................................................................... No. NIK : .................................................................................................... Gol. Darah :.................. Pekerjaan : :..................................................................................................... Nomor Hp/wa : .................................................................................................... Alamat :..................................................................................................... ........................................................................................... Alasan Mengikuti LK1: .................................................................................................... .................................................................................................... .................................................................................................... *Syarat dan Ketentuan Sehat Jasmani dan Rohani Usia 11 s/d 45 Tahun Calon Peserta Berdomisili di Takalar Punya Tanda Pengenal (KTP/KK) Konstribusi 25k