PT.

MERPATI TRAINING CENTER

Jln. H.M. Joni Ruko Puri Teladan No.2 Teladan Barat, Kota Medan
Telp : ( 061 ) 4290 4708
Email : merpatitrainingcentermedan@gmail.com
Website: www.merpatitrainingcentre.com

FOO
FORM PENDAFTARAN
DGCA Approved 141, 142, 147/ISO 9001 : 2008 Certified
1. Please completed the data bellow with block capital letters Photo 3 x 4
2. *Cross where not appropriate

A. PERSONAL DATA
FULL NAME : MALE / FEMALE *
PLACE / DATE of BIRTH :
HEIGHT / WEIGHT : cm / kg
KTP NO. : RELIGION
PASSPORT NO. : NPWP NO.
PHONE NO. : MOBILE NO.
:
ADDRESS
E-MAIL ADDRESS :
HOBBIES : FORMAL EDUCATION :

B. FAMILY
FATHER’S NAME : MOTHER’S NAME :
FATHER’S JOB : PHONE NO. :
MOTHER’S JOB : PHONE NO. :
ADDRESS :

C. FORMAL EDUCATION D. COURSES ATTENDED (If any)

INSTITUTION NAME YEAR INSTITUTION NAME YEAR
1. 1.
2. 2.
3. 3.
4. 4.

E. WORKING EXPERIENCE (If any) F. PERSONAL MOTIVATION (Please describe your strong &
weakness, and also your motivation join with this training)
COMPANY YEAR STRONG
1. WEAKNESS
2.
MOTIVATION
3.

Sincerely,
Trainee Parents,

( ................................................. ) ( ..........................................................................)
Full Name Full Name