No.

: 242

PANITIA PELAKSANA OPEN RECRUITMENT

DAN LEADERSHIP TRAINING
UNIT KEGIATAN MAHASISWA (UKM) BAHASA
POLITEKNIK NEGERI UJUNG PANDANG
Sekretariat: PKM Politeknik Negeri Ujung Pandang
Jln. Perintis Kemerdekaan Km. 10 Tamalanrea Makassar 90245
Telp: 081 234 540 308Email: pnupukmbahasa@gmail.com

REGISTRATION FORM

FULL NAME : NUR ARFYANI PAHNI

NICK NAME : FYA
LEDGER (STAMBUK) : 31220015
DEPARTEMENT : CIVIL ENGINEERING
PLACE AND DATE OF BIRTH : WAJO, SEPTEMBER 1th 2002
SEX : FEMALE
RELIGION : ISLAM
PHONE NUMBER : 085338723398
HOBBY : WATCHING DRAMA
ADDRESS IN MAKASSAR :PERMATA SUDIANG RAYA BLOK K7 NO.19
REGIONAL FROM :WAJO
SCHOOL ORIGION : SENIOR HIGH SCHOOL 5 WAJO
EDUCATION BACKGROUND :
1. ELEMENTARY SCHOOL 6 ONGKOE
2. JUNIOR HIGH SCHOOL 1 BELAWA
3. SENIOR HIGH SCHOOL 5 WAJO
ORGANIZATION EXPERIENCE:
1. ROHIS
2. …………………………………………………………………………………………………..…
3. …………………………………………………………………………………………………..…
LINGUISTICACTIVITIESHAVE BEEN FOLLOWED :
TRAINING : …………………………………………………………………….……………………………………………

COURSE : ENGLISH, MANDARIN, JAPAN, KOREA, ARAB, ……….……………………………………………

CONTEST : …………………………………………………………………….……………………………………………

MAKASSAR ,MARCH 28th 2021

NUR ARFYANI PAHNI

Nb :
❖ Use English and capital letters
❖ Register form must be typed using times new roman font 11 and convert to pdf
❖ Returning form fee is Rp. 15.000,-
❖ Returning form period end on March 28th, 2021
❖ For more information, contact us via WA 081 234 540 308, http://ukmbahasa.poliupg.ac.idor in Secretariat of UKM
Bahasa Politeknik Negeri Ujung Pandang