Data Application UNTIRTA Scholarship
Please fill in all the question required below thoroughly and submit on 29 May 2018, 9.00 am at the latest.

This scholarship is for students with major:
1. Fakultas Hukum
2. Fakultas Ilmu Sosial Politik
3. Fakultas Pertanian
4. Fakultas Teknik
5. Fakultas Ekonomi
6. Fakultas Keguruan dan Ilmu Pendidikan

Please note that we do not proceed students who are not meet our requirements.

Thank you.
PT Chandra Asri Petrochemical Tbk

Required major *
Fullname *
Your answer
Gender *
Active mobile phone *
Your answer
Email *
Your answer
NIM (Nomor Induk Mahasiswa) *
Your answer
Latest GPA (4.00) *
Your answer
SKS Passed *
Your answer
SKS to go *
Your answer
Semester to go *
Your answer
Origin (Asal Daerah) *
Your answer
Previous or current scholarship *
Required
Expired date previous or current scholarship *
Your answer
Parent's Occupation (Pekerjaan Orangtua, Ayah&Ibu)
Your answer
Parent's Income (Penghasilan Orangtua, Ayah&Ibu) *
Your answer
Special achievements *
Your answer
Foreign language skill *
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms