FORMULIR

CALON KANDIDAT KETUA UMUM

BADKO SULUT-GO PERIODE 2021-2023
 BIODATA

CALON KETUA UMUM BADKO SULUT-GO

PERIODE 2021-2023

Pas Photo

I. Data Pribadi

1. Nama Lengkap : ..................................................................................

2. Nama Panggilan : .................................................................................
3. NIK : ..................................................................................
4. Tempat dan Tanggal Lahir : ..................................................................................
5. Jenis Kelamin : ..................................................................................
6. Agama : ..................................................................................
7. Status Pernikahan : ..................................................................................
8. Kewarganegaraan : ..................................................................................
9. Pekerjaan : ..................................................................................
10. Alamat sesuai KTP : Jalan / Kampung : ........................................
RT/RW : ........................................
Desa/Kelurahan : ........................................
Kabupaten/Kota : ........................................
11. Kode Pos : ...........................................................
13. Nomor HP : ..................................................................................
14. e-mail : ..................................................................................
15. Akun Media Sosial : No Whatsapp : ...............................................
Facebook : ...............................................
Twitter : ...............................................
Instagram : ..............................................
Website/Url. : ..............................................
II. Pendidikan Formal :

Periode Sekolah / Institusi / Jurusan Jenjang

Universitas
(Tahun) Pendidikan

-
III. Pendidikan Non Formal / Training – Seminar

Tahun Lembaga / Instansi Keterampilan

IV. Pengalaman Organisasi

Periode Organisasi Jabatan

V. Jenjang Training di HMI

Lokasi Latihan kader Tahun Keterangan

II

III

SC

LKK

Demikian CV ini saya buat dengan sebenarnya.

….…………, …… Januari 2022

(......................................)