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Registrasi Online Beasiswa PPA Universitas Islam Indonesia tahun 2016
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NIM
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PRODI
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FAKULTAS (ex: FH, FTSP, FTI, dll)
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NAMA (huruf besar)
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NAMA DI REKENING (huruf besar)
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NAMA BANK (Mandiri, Bukopin, Muamalat, BSM, BRI)
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NO REKENING
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JENIS KELAMIN (tulis L/P)
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KODE PRODI (cek lampiran)
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SEMESTER (minimal 2, maksimal 6)
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IPK
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PEKERJAAN
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KODE PEKERJAAN (cek Lampiran)
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JUMLAH TANGGUNGAN
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PENGHASILAN
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PRESTASI
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ALAMAT
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TELEPON
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LAMA/BARU
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