FORMULIR PENDAFTARAN CALON KETUA BEM FARMASI 2011/2012
Nama : ............................................................................................
Tempat, Tanggal Lahir : ............................................................................................
Alamat : ............................................................................................
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Nim : ............................................................................................
Angkatan / Kelas : ............................................................................................
Pengalaman Organisasi : ............................................................................................
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IPK : ............................................................................................
Harap melampirkan :
1. Fotocopy KTP asli
2. Fotocopy IP terakhir (IPK)
2. Fotocopy IP terakhir (IPK)
3. Foto 4x6 sebanyak 2 lembar, 3x4 sebanyak 2 lembar
4. Surat Aktif Kuliah.
4. Surat Aktif Kuliah.
..................................................... 2012
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