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Section 1 of 4
FORMULIR PENDAFTARAN PELATIHAN BLK LOMBOK TENGAH BATCH 5 TAHUN 2025
Silahkan memfollow dan/atau mensubcribe media sosial BLK Lombok Tengah dan melampirkan bukti berupa screenshot
1. Facebook
1. Facebook
2. Instagram
3. Youtube
4. Tiktok
Tiktok BLK Lombok Tengah
Tiktok BLK Lombok Tengah
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NIK
NIK
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Nama Lengkap
Nama Lengkap
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Gunakan Huruf Kapital (Contoh : ANITA RAHARJO)
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Tempat Lahir
Tempat Lahir
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Tanggal Lahir
Tanggal Lahir
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Jenis Kelamin
Jenis Kelamin
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1.
Laki-laki
2.
Perempuan
3.
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Golongan Darah
Golongan Darah
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A
B
O
AB
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Agama
Agama
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Islam
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Alamat Jalan/Dusun
Alamat Jalan/Dusun
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(COntoh : Jln Pariwisata No 10 Kute/ Dusun Mong)
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Kecamatan
Kecamatan
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Batukliang
Batukliang Utara
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Kabupaten
Kabupaten
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Kabupaten Lombok Tengah
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Provinsi
Provinsi
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Pendidikan Terakhir
Pendidikan Terakhir
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S2
S1
D1-D3
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SMP Sederajat
SD Sederajat
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Asal sekolah
Asal sekolah
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Tahun Lulus
Tahun Lulus
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No HP
No HP
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Apakah anda sudah memilikI akun SIAPKerja (www.kemnaker.go.id)?
Apakah anda sudah memilikI akun SIAPKerja (www.kemnaker.go.id)?
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Ya
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Apakah Anda Sudah Pernah Mengikuti Pelatihan di BLK Lombok Tengah?
Apakah Anda Sudah Pernah Mengikuti Pelatihan di BLK Lombok Tengah?
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Ya
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Section 2 of 4
PELATIHAN YANG PERNAH DIIKUTI
Silahkan diisi sesuai pelatihan yang pernah diikuti !
Nama kejuruan yang pernah diikuti (CONTOH : DESAIN GRAFIS)
Nama kejuruan yang pernah diikuti (CONTOH : DESAIN GRAFIS)
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Tahun pelatihan yang pernah diikuti (CONTOH : 2020)
Tahun pelatihan yang pernah diikuti (CONTOH : 2020)
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Section 3 of 4
PELATIHAN YANG AKAN DIIKUTI
SIlahkan pilih sesuai dengan minat yang diinginkan
Program Pelatihan Yang Akan diikuti
Program Pelatihan Yang Akan diikuti
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Pelatihan yang akan diikuti di BLK Lombok Tengah
Tata Rias
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Teknisi Handphone
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Tata Boga
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Barista
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Menjahit
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Section 4 of 4
BERKAS PERSYARATAN
Silahkan Upload berkas pendaftaran yang persyaratkan
( Gunakan file *.pdf, *.jpg, *. png, *.bmp)
( Gunakan file *.pdf, *.jpg, *. png, *.bmp)
KTP/Surat Keterangan Domisili
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(Maksimal 1Mb)
KTP/Surat Keterangan Domisili
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(Maksimal 1Mb)
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Ijazah Terahir /atau Surat Keterangan Lulus /atau Surat Keterangan Bisa Baca Tulis
(Maksimal 1Mb)
(Maksimal 1Mb)
Ijazah Terahir /atau Surat Keterangan Lulus /atau Surat Keterangan Bisa Baca Tulis
(Maksimal 1Mb)
(Maksimal 1Mb)
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Kartu Keluarga/KK
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(Maksimal 1Mb)
Kartu Keluarga/KK
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(Maksimal 1Mb)
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Pasphoto Latar Merah
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(Maksimal 1Mb)
Pasphoto Latar Merah
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(Maksimal 1Mb)
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