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FORMULIR CALON LEGISLATIF 2024

DPW PARTAI NasDem JAWA BARAT

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Bakal Calon
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BIODATA
Nama Lengkap : ....................................................................................................
No. KTP : ....................................................................................................
No. KTA : ....................................................................................................
Tempat Tanggal Lahir : ....................................................................................................
Jenis Kelamin : ....................................................................................................
Pendidikan Terakhir : ....................................................................................................
Alamat Lengkap : ....................................................................................................
RT. .............. RW. ................
Desa/Kelurahan : ..................................................................
Kecamatan : ..................................................................
Kabupaten/Kota : ..................................................................
Nomor HP / Telp : ....................................................................................................
Email : ....................................................................................................
Pengalaman Kerja* : ………………………………………………………………………………………………..
Pengalaman Organisasi* : ………………………………………………………………………………………………..
Pengalaman Politik* : ………………………………………………………………………………………………..
*tulis satu pengalaman/jabatan terakhir

DAPIL PENCALEGAN
PILEG 2024 : Dapil ................ DPR RI
: Dapil ................ Provinsi Jawa Barat
: Dapil ................ Kabupaten/Kota : ...........................................

Bandung, ......, .......................... 2022


Calon Legislatif 2024

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