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PENDAFTARAN PESERTA GEOSPACE 2010

FAKULTAS GEOGRAFI UNIVERSITAS GADJAH MADA
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Nama Lengkap / Panggilan : ___

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Jurusan /Program Studic

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Tempat/Tanggal Lahircc
Alamat Asalc 

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Alamat Sekarang:cc
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CP yang bisa dihubungi :c
Asal Sekolahc

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Status Mahasiswaccccccccc
cccc

cc Agamac c Hobi c c c c Prestasi yg pernah diraih :c c c cc c c cc c Kemampuan Bahasa Asing : c  cc c c"# cc c c cc c c"$cc !c cc c c %c Penyakit yg sedang/ pernah diderita : _______________________________________________ ________________________________________________________Gol.darah: A / B / AB / O Alergi makanan : ___________________________________________________________ „$c& .

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c Bacaan (buku/novel/majalah/koran) yang pernah saya baca: c„   .

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%c c c.c.#.

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 c c cccccccccc (c6c)c c c c $$$$$$$$$$$$$$$$$cc cc $$$$$$$$$$$$$$$$$c .

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