Anda di halaman 1dari 1

FORM BIODATA PESERTA AUDISI KONTINGEN TIM PESPARAWI XII PROVINSI BENGKULU

NAMA : ...................................................................................................

TEMPAT/TANGGAL LAHIR (UMUR) : ...................................................................................................

STATUS/PEKERJAAN : ...................................................................................................

ALAMAT : ...................................................................................................

ALAMAT ORANG TUA : ...................................................................................................

NO HP : ...................................................................................................

*CENTANG
NO WA : SAMA LAIN: ...........................................................

ALAT MUSIK YANG DIKUASAI : ...................................................................................................

KEGIATAN YANG DIIKUTI : ...................................................................................................

...................................................................................................

...................................................................................................

...................................................................................................

PRESTASI DAN PENGALAMAN DALAM PADUAN SUARA:

Tanda Tangan

Nama :...........................................

Anda mungkin juga menyukai