I.

II.

Personal Identity
Name
Address
Address in Malang
Place and Day of Born
Phone Number
Gender
Religion
Nation
Marital Status
Elementary School
Junior High School
Senior High School
Hoby

: Ismail Wahyudi
: Jl. Raya Sumbertangkil, Tirtoyudo, Malang
: Jl. Kembangturi 3 Malang
: Malang, July 9th 1996
: 085608085164
: Male
: Moslem
: Indonesian
: Single
: State Elementary School 1 Sumbertangkil
: PGRI Junior High School 4 Tirtoyudo
: State Senior High School 1 Turen
: Futsall

Parent Identity
Name
Address
Place and Day of Born
Phone Number
Gender
Religion
Marital Status
Occupation

: Dwi Hardi
: Jl. Raya Sumbertangkil, Tirtoyudo, Malang
: Malang, August 7th 1985
: 081331335974
: Male
: Moslem
: Married
: Repairmen

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