Professional Documents
Culture Documents
Registration Form/Formulir Pendaftaran
Registration Form/Formulir Pendaftaran
ANCASILA
PROGRAM MAGISTER ILMU KEFARMASIAN
KEFARMASIAN
Srengseng Sawah, Jagakarsa, Jakarta 12640_______________
Jakarta 12640________________
UNIVERSITAS P
PROGRAM MAGISTER ILMU
Srengseng Sawah, Jagakarsa,
(Full
name of candidate)
KELENGKAPAN PENDAFTARAN
1. Mengisi dan menandatangani Formulir Pendaftaran
2. Pembayaran uang pendaftaran Rp.200.000,= melalui
ATM/transfer ke
Magister Farmasi Universitas Pancasila
Bank Mandiri Cabang Universitas Pancasila
No. Acc. 127.009.401.555.7
(Formulir Pendaftaran dan bukti transfer/ATM
dapat dikirimkan via
email atau fax)
3. Sertifikat TOEFL test (tidak/belum dibatasi masa laku maupun
nilai test)
4. Pasfoto berwarna latar belakang ungu 2x3cm 4 lembar
3x4cm 4 lembar
4x6cm 4 lembar
5. Fotokopi KTP
6. Mengisi Biodata (dapat menyusul)
7. Tes akademik dan wawancara (dapat menyusul)
House Phone
Handphone
E-mail Address
Graduated from :
University
Faculty/Program
Year of graduation
To be filled by working/employee candidates
Company Name
Job Position
Preferred Area of
Study
Information / Return to : Detty or Alam Asgar
Phone : +62 21 786 4727
Fax
: +62 21 786 4723
Jakarta,
Signature