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  • Formulir Pendaftaran Binadarma

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    DolphinetAja
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    formulir pendaftaran binadarma

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    formulir pendaftaran binadarma

    Copyright:

    © All Rights Reserved
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    6 views1 page

    Formulir Pendaftaran Binadarma

    Uploaded by

    DolphinetAja
    formulir pendaftaran binadarma

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    FORMULIR PENDAFTARAN PESERTA

    KULIAH KERJA PRAKTEK (KKP)


    PROGRAM STUDI TEKNIK INFORMATIKA
    PERIODE GENAP 2017/2018

    NAMA
    NIM 142 P/N *coret yang tidak perlu
    TEMPAT LAHIR & TGL LAHIR / /
    ALAMAT RUMAH
    (DI PALEMBANG)

    NO. TELPON RUMAH


    NOMOR PONSEL / HP
    JUMLAH SKS TEMPUH
    UKURAN JAKET S M L XL XXL * bagi peserta KI (harap dilingkari)
    ALAMAT E-MAIL
    FACEBOOK
    TWITTER
    ORANG TUA / WALI MAHASISWA
    NAMA
    ALAMAT RUMAH

    NO. TELEPON RUMAH


    NO. PONSEL / HP

    PILIHAN KEGIATAN
    (Berilah tanda  dan Lingkari)
    KKP MAGANG Mandiri (Tempat Kerja) / Bukan
    Nama Perusahaan :_______________________________________
    Alamat :________________________________________________
    ________________________________________________

    KKP SIT IN

    KKP KUNJUNGAN INDUSTRI Dalam Negeri / Luar Negeri

    PILIHAN KKP :

    1._____________________

    2._____________________

    Palembang,________________2017

    (____________________________)
    Nama jelas dan tanda tangan

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