FORMULIR PENDAFTARAN
FUNGSIONARIS KSR
ANGKATAN XXV
BIODATA MAHASISWA
1. NAMA LENGKAP : .................................
2. NAMA PANGGILAN : ..................................
3. NIM / KELAS : ..................................
4. TTL : ..................................
5. ALAMAT ASAL : ..................................
6. ALAMAT KOS : ..................................
7. NO. TELP. / HP : ..................................
8. ALAMAT FB : ..................................
9. PENGALAMAN BERORGANISASI :
a. ....................................................
b. ....................................................
c. ....................................................
10. PELATIHAN YANG PERNAH DIIKUTI :
a. ....................................................
b. ....................................................
c. ....................................................
11. MOTIVASI MASUK KSR : ...............................
12. HOBI : ...............................
13. MOTTO HIDUP : ...............................
Semarang,
NIM.
NB. Harap diisi dengan jujur dan lengkap
FUNGSIONARIS KSR
ANGKATAN XXV
BIODATA MAHASISWA
1. NAMA LENGKAP : .................................
2. NAMA PANGGILAN : ..................................
3. NIM / KELAS : ..................................
4. TTL : ..................................
5. ALAMAT ASAL : ..................................
6. ALAMAT KOS : ..................................
7. NO. TELP. / HP : ..................................
8. ALAMAT FB : ..................................
9. PENGALAMAN BERORGANISASI :
a. ....................................................
b. ....................................................
c. ....................................................
10. PELATIHAN YANG PERNAH DIIKUTI :
a. ....................................................
b. ....................................................
c. ....................................................
11. MOTIVASI MASUK KSR : ...............................
12. HOBI : ...............................
13. MOTTO HIDUP : ...............................
Semarang,
NIM.
NB. Harap diisi dengan jujur dan lengkap
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