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  • Formulir Pendaftaran Pencak Silat Tadjimalela Subang

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    Ichsan Muiz
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    Yang ingin menjadi anggota tadjimalela subang silahkan ambil formulir pendaftarannya ini.

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    Yang ingin menjadi anggota tadjimalela subang silahkan ambil formulir pendaftarannya ini.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    11K views1 page

    Formulir Pendaftaran Pencak Silat Tadjimalela Subang

    Uploaded by

    Ichsan Muiz
    Yang ingin menjadi anggota tadjimalela subang silahkan ambil formulir pendaftarannya ini.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    FORMULIR PENDAFTARAN

    Unit Latihan : ..................................................................................


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

    Tempat/Tgl Lahir : ..................................................................................

    Jenis Kelamin : ..................................................................................

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

    Pendidikan :.................................................................................................................

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

    Alamat Lengkap : ................................................................................................................

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

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

    Pernah Mengikuti Beladiri : Pernah / Belum *) (.................................................)

    Nama Orang Tua/ Wali : ...............................................................................................................

    Alamat Orang Tua/ wali : ...............................................................................................................

    No. Telp/Hp : ...............................................................................................................

    “Saya berjanji akan mematuhi semua peraturan-peraturan yang berlaku dalam latihan perguruan silat
    Tadjimalela, dan akan berlatih dengan tekun serta menghormati pelatih, pengurus dan sesama
    Tadjimalela”

    Subang, ........................ 20...

    Mengetahui,

    Orang Tua/ Wali Murid Pemohon

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

    *) Coret yang tidak perlu www.tadjimalelasubang.co.cc

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