Formulir Pendaftaran

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Formulir Pendaftaran
UKPM Birama UNIKOM 2010
Dengan ini saya,

Nama : ......................................................................................................................................

Jurusan : ........................................................................ Angkatan : ..............................

TTL : ........................................................................ Umur : ..............................

No. Telepon : .......................................................................

Minat : ......................................................................................................................................

Bakat : ......................................................................................................................................

Motivasi masuk BIRAMA

: ...................................................................................................................................................
...............

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

Klub favorit : Jurnalistik Puisi Teater

*Lingkari salah satu

menyatakan diri bergabung ke dalam Unit Kegiatan Pers Mahasiswa BIRAMA UNIKOM periode 2010.

Bandung, ..............................

Foto 3x4

(..............................................)

UKPM BIRAMA UNIKOM

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