You are on page 1of 1

Pas Foto IDENTITAS PESERTA MAGANG

PT Rama Emerald Multi Sukses

Nama : …………………………………………………………………………………………
Nomor Induk Siswa : …………………………………………………………………………………………
Asal Sekolah : ………………………………………………………………………………………...
Jurusan : …………………………………………………………………………………………
Jenis Kelamin : …………………………………………………………………………………………
Tempat, tanggal lahir : …………………………………………………………………………………………
Alamat Peserta Magang : …………………………………………………………………………………………
No. Telp Peserta Magang : …………………………………………………………………………………………
Nama Orang Tua : …………………………………………………………………………………………
Alamat Orang Tua : …………………………………………………………………………………………
No. Telp Orang Tua : …………………………………………………………………………………………

...................... , ……………………...........

(……………………….…………………)

You might also like