Download Form Pendaftaran Jambore Pelajar Teladan Bangsa 2017 PDF

TitleForm Pendaftaran Jambore Pelajar Teladan Bangsa 2017
File Size27.6 KB
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FORMULIR PENDAFTARAN PESERTA
Jambore Pelajar Teladan Bangsa 2017

Saya yang bertanda tangan dibawah ini:

Nama : .......................................................................................... ( L / P )

Tempat, Tanggal Lahir : .......................................................................................................

Alamat Rumah : .......................................................................................................

Telp./HP. : .......................................................................................................

Email : .......................................................................................................

Sekolah : .............................................................................. Kelas : ............

Alamat Sekolah : .......................................................................................................

Email Sekolah : .......................................................................................................

Telp. & Fax. Sekolah : …………....................................... Fax. ......................................

Telp./HP keluarga : …………................................................... (ayah/ibu/kakak/adik)

Ukuran baju : ( S, M, L, XL, XXL, XXXL )

Blog : .......................................................................................................

Facebook : .......................................................................................................

Twitter : .......................................................................................................

Path : .......................................................................................................

Instagram : .......................................................................................................

Youtube : .......................................................................................................

Hobi : .......................................................................................................

Minat : .......................................................................................................

Aktivitas Ekskul (Sekolah) : .......................................................................................................

Aktivitas Organisasi : .......................................................................................................

(Luar Sekolah) .......................................................................................................

Buku Apa Saja yang Pernah Dibaca (sebutkan minimal 3 buku):

1. ................................................................................................................................................

2. ................................................................................................................................................

3. ................................................................................................................................................

Majalah Apa Saja yang Pernah Dibaca (sebutkan minimal 3 majalah):

1. ................................................................................................................................................

2. ................................................................................................................................................

3. ................................................................................................................................................

Koran Apa Saja yang Sering Dibaca (sebutkan 3 koran yang sering dibaca):

Foto

3 x 4

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