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  • Revisi Formulir Pendaftaran Pec 2019

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    Cindya Febrianti
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    The document is a registration form for the 2019 POLKESMA English Competition. It requests information from participants such as name, student ID number, date of birth, grade/study program, and major. The competition includes categories for English debate with 3 speakers, public speaking events like storytelling, oratory and news anchoring with 1-3 participants each, and an official role. Participants are asked to submit photocopies of their student ID cards or delegation letters and bring the originals for verification at registration before the competition.

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    REVISI FORMULIR PENDAFTARAN PEC 2019.doc

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    The document is a registration form for the 2019 POLKESMA English Competition. It requests information from participants such as name, student ID number, date of birth, grade/study program, and major. The competition includes categories for English debate with 3 speakers, public speaking events like storytelling, oratory and news anchoring with 1-3 participants each, and an official role. Participants are asked to submit photocopies of their student ID cards or delegation letters and bring the originals for verification at registration before the competition.

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    © All Rights Reserved
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    15 views3 pages

    Revisi Formulir Pendaftaran Pec 2019

    Uploaded by

    Cindya Febrianti
    The document is a registration form for the 2019 POLKESMA English Competition. It requests information from participants such as name, student ID number, date of birth, grade/study program, and major. The competition includes categories for English debate with 3 speakers, public speaking events like storytelling, oratory and news anchoring with 1-3 participants each, and an official role. Participants are asked to submit photocopies of their student ID cards or delegation letters and bring the originals for verification at registration before the competition.

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    © All Rights Reserved
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    of 3

    KEMENTERIAN KESEHATAN REPUBLIK INDONESIA

    POLITEKNIK KESEHATAN KEMENKES MALANG


    BADAN EKSEKUTIF MAHASISWA
    Jalan Besar Ijen No. 77 c Malang. 65112. Telepon 085736591475
    Website: http://www.bempolkesma.wix.com Email: bem.polkesma@gmail.com

    REGISTRATION FORM
    POLKESMA ENGLISH COMPETITION 2019

    A. ENGLISH DEBATE

    1. Speaker 1

    Name

    Student ID Number

    Date Of Birth

    Grade/Study Program

    Major

    2. Speaker 2

    Name

    Student ID Number

    Date Of Birth

    Grade/Study Program

    Major

    3. Speaker 3

    Name

    Student ID Number

    Date Of Birth

    Grade/Study Program

    Major

    B. PUBLIC SPEAKING
    KEMENTERIAN KESEHATAN REPUBLIK INDONESIA
    POLITEKNIK KESEHATAN KEMENKES MALANG
    BADAN EKSEKUTIF MAHASISWA
    Jalan Besar Ijen No. 77 c Malang. 65112. Telepon 085736591475
    Website: http://www.bempolkesma.wix.com Email: bem.polkesma@gmail.com

    1. Story Telling

    Name

    Student ID Number

    Date Of Birth

    Grade/Study Program

    Major

    2. Oratory

    Name

    Student ID Number

    Date Of Birth

    Grade/Study Program

    Major

    3. News Anchor

    Name

    Student ID Number

    Date Of Birth

    Grade/Study Program

    Major

    C. OFFICIAL
    KEMENTERIAN KESEHATAN REPUBLIK INDONESIA
    POLITEKNIK KESEHATAN KEMENKES MALANG
    BADAN EKSEKUTIF MAHASISWA
    Jalan Besar Ijen No. 77 c Malang. 65112. Telepon 085736591475
    Website: http://www.bempolkesma.wix.com Email: bem.polkesma@gmail.com

    Name

    Student ID Number

    Date Of Birth

    Grade/Study Program

    Major

    …………,………………..2019
    Official Tim

    ………………………..

    Catatan : Dilampirkan fotocopy Kartu Tanda Mahasiswa/Surat tugas (delegasi) dan peserta
    dimohon membawa serta menunjukkan KTM/Surat tugas (delegasi) asli saat registrasi sebelum
    perlombaan.

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