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FORMULIR PENDAFTARAN ONLINE MAHASISWA BARU SEKOLAH TINGGI ILMU EKONOMI (STIE) YASMI CIREBON
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DATA CALON MAHASISWA BARU
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Nama Lengkap
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Nama Harus Sesuai Dengan Ijazah
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Tempat Lahir
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Tanggal Lahir
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MM
/
DD
/
YYYY
Jenis Kelamin
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Laki-Laki
Perempuan
Agama
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Islam
Kristen
Hindu
Budha
Golongan Darah
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A
B
O
AB
Alamat Lengkap
Tuliskan nama jalan , Gang dan nomor rumah
Jalan
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RW
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Ditulis dengan angka
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RT
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Ditulis dengan angka
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Kelurahan/Desa
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Kecamatan
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Kota/Kabupaten
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Asal Sekolah
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Nomor Induk Siswa Nasional (NISN)
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Nomor HP/WA
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