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PT.

Cahaya Pendidikan Internasional


(Bright Education Indonesia)
Jl. Sukarajin I No.1, Kel. Pasirlayung, Kec. Cibeunying Kidul
Kota Bandung, Jawa Barat 40125
www.brighteducation.id | +62-877-1757-0174 | info@brighteducation.id

FORMULIR PENDAFTARAN
PROGRAM JERMAN
BRIGHT EDUCATION INDONESIA
Pas Foto 3x4
A. Data Pribadi

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

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

Jenis Kelamin : Perempuan Laki-laki

Tinggi Badan : ..........cm. Berat Badan : ..........Kg.

No. KTP / Passport : ............................................................

Alamat Sesuai KTP : ...............................................................................................

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

Alamat Domisili : ...............................................................................................

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

Email : ...............................................................................................

No. Telepon / HP : ............................................................

No. WhatsApp : ............................................................


(Apabila Berbeda)

Akun Instagram : ............................................................


(Apabila Terdapat)

B. Data Orang Tua / Wali*

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

Alamat Tinggal : ...............................................................................................

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

Hubungan : ...............................................................................................

Bright Education Indonesia © 2022 All Rights Reserved


PT. Cahaya Pendidikan Internasional
(Bright Education Indonesia)
Jl. Sukarajin I No.1, Kel. Pasirlayung, Kec. Cibeunying Kidul
Kota Bandung, Jawa Barat 40125
www.brighteducation.id | +62-877-1757-0174 | info@brighteducation.id

Pekerjaan : ............................................................

No Telepon / HP : ............................................................

No. WhatsApp : ............................................................


(Apabila Berbeda)

C. Data Sekolah / Instansi

Asal Sekolah / Instansi : .........................................................................

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

Program yang akan diikuti:

FSJ/Au-Pair Ausbildung

Study Abroad Jurusan(opsional) Administrasi Teknik

German Language Couse Perhotelan Koki

Nurse Lainnya …………………………………

Direkomendasikan Oleh: .....................................................................................................


(Apabila Terdapat. Contoh: Badan/Lembaga/Perseorangan/Iklan/dll..)

___________,_____________________
(kota, tanggal)

Orangtua/Wali Peserta
(TTD & Nama Lengkap) (TTD & Nama Lengkap)

______________________ __________________

Bright Education Indonesia © 2022 All Rights Reserved

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