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FORMULIR PENDAFTARAN EDUTISI 2023
BYRCC KE-13 TINGKAT PMR WIRA SE-BANTEN OPEN
No. Pendaftaran ............................................... (Diisi Panitia saat registrasi ulang)
Nama sekolah : SMAN 1 Ciruas
Alamat sekolah : Jl. Raya Jakarta No. Km. 9, RW.5, Citerep, Kc. Ciruas, Kabupaten serang, Banten
No. Pembina : 0852-1405-5833
No. Ketua/Anggota PMR : 0821-1106-1231
1. Pertolongan Pertama
No Nama Peserta
1. Halga Carissa Anindita
2. M. Devan Agustino
3. Kinanti Fatma Tifani
4. Yasmin Zuhairo javani
2. Ayo Siaga Bencana
No Nama Peserta
1. AL Fath Raya Maulana
2. Asti Zahratul Ilmi
3. Fina Anggraeni
3. Donor Darah
No Nama Peserta
1. M. Abdiel Azis
2. Jesica Indah
4. Gerakan Kepalangmerahan
No Nama Peserta
1. Ilham Bintang
*Hal-hal yang belum jelas pada juknis, akan dibahas pada saat technical meeting.
Serang, 26 September 2023
Mengetahui,
Korps Sukarela PMI UPT Universitas Sultan Ageng Tirtayasa, Jl. Raya Jakarta KM 04 Pakupatan
42111. Serang. Banten. HP. 0898-3088-831 (Elbirra), 0877-6840-6362 (Tri Ayu)

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Formulir Pendaftaran BYRCC 2023_SMAN 1 Ciruas.pdf

  • 1. FORMULIR PENDAFTARAN EDUTISI 2023 BYRCC KE-13 TINGKAT PMR WIRA SE-BANTEN OPEN No. Pendaftaran ............................................... (Diisi Panitia saat registrasi ulang) Nama sekolah : SMAN 1 Ciruas Alamat sekolah : Jl. Raya Jakarta No. Km. 9, RW.5, Citerep, Kc. Ciruas, Kabupaten serang, Banten No. Pembina : 0852-1405-5833 No. Ketua/Anggota PMR : 0821-1106-1231 1. Pertolongan Pertama No Nama Peserta 1. Halga Carissa Anindita 2. M. Devan Agustino 3. Kinanti Fatma Tifani 4. Yasmin Zuhairo javani 2. Ayo Siaga Bencana No Nama Peserta 1. AL Fath Raya Maulana 2. Asti Zahratul Ilmi 3. Fina Anggraeni 3. Donor Darah No Nama Peserta 1. M. Abdiel Azis 2. Jesica Indah 4. Gerakan Kepalangmerahan No Nama Peserta 1. Ilham Bintang *Hal-hal yang belum jelas pada juknis, akan dibahas pada saat technical meeting. Serang, 26 September 2023 Mengetahui, Korps Sukarela PMI UPT Universitas Sultan Ageng Tirtayasa, Jl. Raya Jakarta KM 04 Pakupatan 42111. Serang. Banten. HP. 0898-3088-831 (Elbirra), 0877-6840-6362 (Tri Ayu)