FORMULIR PENDAFTARAN ONLINE UNIVERSITAS MALAHAYATI
DATA CALON MAHASISWA
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Nama Calon Mahasiswa
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Tempat Lahir
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Tanggal Lahir
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Jenis Kelamin
Agama
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Kewarganegaraan
Status Sipil
Status Kepegawaian
Alamat Tempat Tinggal
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Kode Pos
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Jenis Tempat Tinggal
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Nomor Telepon / HP
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Email
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Pendidikan Terakhir
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Jurusan
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ASAL SEKOLAH / PT
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Nomor STTB / Ijazah
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Nilai Ujian Nasional / IPK
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