Formulir Data Mahasiswa STAIS
Data mahasiswa baru 2018-2019
Nama Lengkap *
Your answer
Prodi *
Kelas Perkuliahan *
Tempat lahir *
Your answer
Tanggal lahir *
MM
/
DD
/
YYYY
Jenis Kelamin *
Agama *
Required
Nama Ibu *
Your answer
Nomor KTP/NIK *
Your answer
Asal Sekolah *
Your answer
Jurusan *
Your answer
Tahun Lulus *
Your answer
NISN (Jika ada)
Your answer
NPWP (Jika ada)
Your answer
Kewarganegaraan *
Your answer
Alamat *
Your answer
Kelurahan
Your answer
Kecamatan
Your answer
Kota/Kabupaten
Your answer
Kode Pos
Your answer
Telepon
Your answer
Nomor HP *
Your answer
Alamat Email *
Your answer
Sumber Biaya Kuliah *
Required
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