JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Form Registrasi
Desak Anies Surabaya
Desak Anies Surabaya
DBL Arena, Jl. Ahmad Yani No. 88, Ketinang Kec. Gayungan, Surabaya.
Jumat, 9 Februari 2024
18.00 WIB
CP : 081398814504 (Edo)
* Indicates required question
Email
*
Your email
Nama
*
Your answer
Usia
*
Your answer
Lembaga/Organisasi
*
Your answer
Kota Asal
*
Your answer
Pekerjaan
*
Your answer
No. Whatsapp
*
Your answer
Social Media (Instagram/Twitter/TikTok)
Your answer
Alasan kenapa kamu ikut Desak Anies?
*
Your answer
Apakah anda membutuhkan fasilitas untuk penyandang disabilitas?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of gagasanid.org.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report