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KEMENTERIAN PENDIDIKAN, KEBUDAYAAN,

RISET, DAN TEKNOLOGI


BALAI GURU PENGGERAK KALIMANTAN TENGAH
Jalan Tjilik Riwut Km.5.5 Palangkaraya 73112
Telepon (0536) 4279030, Email: bgpkalteng@kemdikbud.go.id
Laman: http://bgpkalteng.kemdikbud.go.id

Biodata Fasilitator
Kegiatan ..........................................................................
di Kabupaten ................................
Tanggal ...............

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Unit Kerja/Instansi : ...............................................................................................

Alamat Kantor : ...............................................................................................

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NPWP : ...............................................................................................

Tempat, Tanggal Lahir : ...............................................................................................

Pendidikan Terakhir : ...............................................................................................

No. Telp/HP : ...............................................................................................

Alamat Rumah : ...............................................................................................

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