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DATA OTA GENTING ASN PWK. BKKBN SUMSEL
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Kabupaten/Kota
*
Provinsi
Ogan Komering Ulu
Ogan Komering Ilir
Muara Enim
Lahat
Musi Rawas
Musi Banyuasin
Banyuasin
OKU Timur
OKU Selatan
Ogan Ilir
Empat Lawang
PALI
Musi Rawas Utara
Palembang
Pagaralam
Lubuk Linggau
Prabumulih
Other:
Jenis Tim
*
Tim 1 (Rp 450.000/bulan)
Tim 2 (Rp 225.000/bulan/orang)
Tim 3 (Rp 150.000/bulan/orang)
Tim 4 (Rp 112.500/bulan/orang)
Tim 5 (Rp 90.000/bulan/orang)
Tim 6 (Rp 75.000/bulan/orang)
Tim 9 (Rp 50.000/bulan/orang)
Nama Anggota Tim
*
Silahkan diisi nama-nama lengkap seluruh anggota tim
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