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Formulir DAM IMM Sleman 2012
Formulir Pendaftaran Darul Arqom Madya PC. IMM Sleman DIY
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Nama Lengkap
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Nama Panggilan
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Delegasi
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Jenis Kelamin
Laki-Laki
Perempuan
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Tempat Tanggal Lahir
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Alamat Asal
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Alamat Sekarang
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No. Telp/Hp
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email
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facebook
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twitter
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Pin BB
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web/blog
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Golongan Darah
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Hobi
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Riwayat Pendidikan
SD/MI/tahun
contoh: SD Muhammadiyah 1 Yogyakarta/1998
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SMP/MTs/tahun
contoh: SMP Muhammadiyah 1 Yogyakarta/2011
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SMA/MA/tahun
contoh: SMA Muhammadiyah 1 Yogyakarta/2010
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univ/PT
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Pengalaman Organisasi
Organisasi/Jabatan/Periode
contoh: PR. IPM SMA M 1 Yogyakarta/Ketua Umum/2009-2010
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Pengkaderan Utama IMM yang Pernah Diikuti
Pengkaderan/Tahun/Tempat
DAD PK. IMM Saintek UIN Sunan Kalijaga/2010/Yogyakarta
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Pengkaderan/Pelatihan Lain yang Pernah Diikuti
Training/Tahun/Tempat
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Kemampuan Baca Al Qu'an
Sangat Baik
Baik
Sedang
Kurang
Tidak Bisa
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Kemampuan Hafal Al Qu'an
Kurang dari 1 juz
1-2 juz
2-5 juz
5-20 juz
20-30 juz
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Apakah anda bisa membaca kitab Arab (tanpa harakat)?
Bisa
Kurang Lancar
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Target yang ingin diraih dalam mengikuti DAM
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Motivasi mengikuti DAM
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