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REGISTRASI KEMAHASISWAAN TAHUN 2016 / 2017
NOTE :
- Foto dikirim ke email idayuri@yahoo.com, dengan subjek registrasi Mahasiswa 2016/2017
- Nama file foto diganti dengan Nama Lengkap dan NIM,
CONTOH :
Ardiansyah C11111117
Nama Lengkap *
Your answer
No. Induk Mahasiswa *
Your answer
Jalur Masuk *
Your answer
Phone number *
Your answer
Tempat / Tanggal Lahir *
Your answer
Jenis Kelamin *
Jumlah Saudara
Your answer
Status rumah yang dihuni *
Orang Tua
Keluarga
Kontrak
Pondokan
Status rumah yang dihuni
Alamat *
Your answer
RT/RW *
Your answer
Kode Pos *
Your answer
HP *
Your answer
Telpon Rumah
Your answer
Asal Sekolah (SLTA) *
Your answer
Kodya/Kab *
Your answer
Provinsi *
Your answer
Lulus Tahun *
Your answer
No. Ijazah *
Your answer
Jumlah NEM *
Your answer
Agama *
Suku *
Your answer
Email *
Your answer
Program Pilihan *
Prestasi (SMA) - Akademik
Your answer
Prestasi (SMA) - Non Akademik
Your answer
Bakat dan Minat - Olahraga
Your answer
Bakat dan Minat - Kesenian
Your answer
Nama Ayah *
Your answer
Agama *
Pekerjaan / Jabatan *
Your answer
Unit Kerja
Your answer
Pendidikan Terakhir *
Your answer
Penghasilan Perbulan *
Your answer
No. Telp/Email *
Your answer
Nama Ibu *
Your answer
Agama *
Pekerjaan / Jabatan *
Your answer
Unit Kerja
Your answer
Pendidikan Terakhir *
Your answer
Penghasilan Perbulan
Your answer
No. Telp/Email
Your answer
Alamat Orang Tua *
Your answer
RT/RW
Your answer
Kode Pos
Your answer
Telp
Your answer
No. Telp. Orang Tua
Your answer
Daya Listrik Rumah Orang Tua (Dalam satuan Watt) *
Your answer
Nama Wali
Your answer
Pekerjaan
Your answer
Penghasilan Perbulan
Your answer
Pendidikan Terakhir
Your answer
Alamat
Your answer
Telp
Your answer
No. Telp/Email
Your answer
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