(PASKIBRA)
KABUPATEN DOMPU
MASSA BAKTI 2023/2024
FORMULIR PENDAFTARAN
CALON KETUA PASKIBRA 2023/2024
Nama : ______________________________________
NISN : ______________________________________
Kelas : ______________________________________
Tempat. Tanggal Lahir : ________________________________
Alamat Rumah : ________________________________
Nomor Telp, / HP : ______________________________________
Cita – cita : ______________________________________
Motto Hidup : ______________________________________
PENGALAMAN BERORGANISASI : ________________Jabatan________________
________________Jabatan________________
________________Jabatan________________
PRESTASI
** AKADEMIK : ______________________________________
MISI
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