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LEMBAGA KURSUS DAN PELATIHAN ( LKP )

SYNERGY COMPUTER CENTER


Alamat : Perumahan Taman Bunga Wisata Blok D No.13 Desa Firdaus Kec. Sei Rampah Kab. Serdang Bedagai
Email : lkpsynergy@gmail.com CP : 081264520050

INDENTITAS SISWA PRAKERIN

Nomor Urut : ..................................................................................

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

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

Jenis Kelamin : Laki - laki Perempuan

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Tingkat/Kompetensi Keahlian : ..................................................................................

Alamat : ..................................................................................

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

No. Telp/ HP Orang Tua/Wali : ..................................................................................

Agama : ..................................................................................

Catatan Kesehatan : ..................................................................................

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Gelombang : Pagi ( Pukul 08.00 – 11.30 WIB)


Siang ( Pukul 13.30 – 17.00 WIB)

CEO LKP SYNERGY COMPUTER CENTER

DONNY R.P SITINJAK, S.Pd

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