JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Formulir Penerimaan Mahasiswa Baru T.A 2023/2024
DATA YANG DIISI HARUS BENAR
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Nama Calon Mahasiswa
*
Your answer
Program Studi Pilihan
*
SARJANA KEPERAWATAN & PROFESI NERS
SARJANA ADMINISTRASI RUMAH SAKIT
SARJANA INFORMATIKA KESEHATAN
SARJANA KESELAMATAN & KESEHATAN KERJA
DIPLOMA TIGA KEPERAWATAN
Email Aktif
*
Your answer
No. HP/ Whatsapp Calon Mahasiswa
*
Your answer
No. HP Orangtua
*
Your answer
Asal Sekolah
*
Your answer
Sumber Informasi
*
Teman
Keluarga
Sosialisasi Sekolah
Sosial Media
Gereja
Alumni STIKES Gunung Maria
Provinsi
*
Your answer
Kecamatan
*
Your answer
Kabupaten/ Kota
*
Your answer
Desa/ Kelurahan
*
Your answer
SILAHKAN KLIK LINK dibawah ini untuk join Grup Whatsapp PMB 2023 untuk memudahkan informasi terkait PMB
https://chat.whatsapp.com/Be7Tw0OCGITKH7UvBqWTMF
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report