DEWAN PIMPINAN WILAYAH V (DPW V)

HIMPUNAN MAHASISWA PARIWISATA INDONESIA

POLITEKNIK NEGERI BALI
Jalan Kampus Bukit Jimbaran, Kuta Selatan, Kabupaten Badung, Bali
Surel: hmpidpw5@gmail.com
Telp: 083147744366 / 081238065312
Laman: https://hmpi.id

FORMULIR PENDAFTARAN
Nama : ...................................................................................................
Tempat/Tanggal Lahir : ...................................................................................................
Kelas/Prodi : ...................................................................................................
3x4
Semester : ...................................................................................................
NIM : ...................................................................................................
No. Telepon : ...................................................................................................

Alamat Saat Ini : ...................................................................................................

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Alamat Asal : ...................................................................................................
Pengalaman Organisasi : ...................................................................................................
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Tujuan Mengikuti HMPI : ...................................................................................................
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Mengetahui
Orang Tua/Wali Mahasiswa, Hormat Saya,

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