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Formulir pendaftaran
- 1. “ Mohon diisi dengan rapi dan lengk ap ” FORMULIR PENDAFTARAN PESERTA PELATIHAN KOMPUTER ISHLAH COMP Blok Senin Desa Kertajati Kec. Kertajati Kab. Majalengka Nomor Pendaftaran*) : ………………………………………………..…………….. Nama Lengkap : ........................................................................................ Nama Penggilan : ........................................................................................ Tempat/Tanggal Lahir : ........................................................................................ Jenis Kelamin**) : Laki – laki / Perempuan Alamat : ........................................................................................ ........................................................................................ Telp./Hp : ................................ Sekolah : ........................................... Identitas Orang Tua : Ayah : ................................................................ Ibu : ................................................................ ............................................. 2014 Pendaftar, ( ________________ )