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  • Championship Astek Exist Sampurna Sumedang Rev

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    eno wijaya
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    The document is a registration form for the Championship Daihatsu Astec Jawa Barat Open 2019 badminton tournament to be held from July 1-6, 2019 in Bandung, Indonesia. It requests information such as name, gender, date of birth, nationality and passport details for 2 officials and 12 players on the Exist Sampurna Sumedang team. The completed form must be returned by email to the PBSI Jawa Barat tournament organizers by June 8, 2019.

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    CHAMPIONSHIP ASTEK EXIST SAMPURNA SUMEDANG REV.docx

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    The document is a registration form for the Championship Daihatsu Astec Jawa Barat Open 2019 badminton tournament to be held from July 1-6, 2019 in Bandung, Indonesia. It requests information such as name, gender, date of birth, nationality and passport details for 2 officials and 12 players on the Exist Sampurna Sumedang team. The completed form must be returned by email to the PBSI Jawa Barat tournament organizers by June 8, 2019.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    Download as docx, pdf, or txt
    31 views2 pages

    Championship Astek Exist Sampurna Sumedang Rev

    Uploaded by

    eno wijaya
    The document is a registration form for the Championship Daihatsu Astec Jawa Barat Open 2019 badminton tournament to be held from July 1-6, 2019 in Bandung, Indonesia. It requests information such as name, gender, date of birth, nationality and passport details for 2 officials and 12 players on the Exist Sampurna Sumedang team. The completed form must be returned by email to the PBSI Jawa Barat tournament organizers by June 8, 2019.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    of 2

    CHAMPIONSHIP DAIHATSU ASTEC JAWA BARAT OPEN 2019

    1-6 JULY ,2019 Bandung, Jawa Barat

    Registration Form
    (Kindly Print in Block Letters)

    A. Country: INDONESIA

    B. Name of Team: EXIST SAMPURNA SUMEDANG

    C. Full Name (Mr./Mrs./Ms.) of Officials:


    a) Officials
    Surname Given Name Gender Date of Birth Nationality Passport No. Expiry Date Position
    HERDIA HERDIAW
    1 HERDIAWAN 06-09-1987 INDONESIA COACH
    WAN AN
    2
    3

    b) Players
    Surname Given Name Gender Date of Birth Nationality Passport No. Expiry Date
    1 NABILA RIFA SITI NABILA GIRL 16-10-2003 INDONESIA
    WINDY AULIA
    2 PUTRI GIRL 06-07-2003 INDONESIA
    PUTRI
    3 DENINRA FAUZIE DENINRA BOY 10-09-2004 INDONESIA
    DEZAN JANUAR
    4 BUDIMAN BOY 06-01-2005 INDONESIA
    BUDIMAN
    RICHA FATILAH
    5 TAOPAN GIRL 05-12-2005 INDONESIA
    TAOPAN
    CHAMPIONSHIP DAIHATSU ASTEC JAWA BARAT OPEN 2019
    1-6 JULY ,2019 Bandung, Jawa Barat
    ALVENNIAS
    6 LAOLI ANUGRAH BOY 11-10-2007 INDONESIA
    SAPUTRA LAOLI
    MOCHAMMAD
    DAFVANSYA
    7 KURNIAWAN BOY 29-03-2010 INDONESIA
    ALDZIEKRA
    KURNIAWAN
    JIHAN ALYA
    8 GHISANI GIRL 25-04-2010 INDONESIA
    GHISANI
    GAMMA KHAIRUL
    9 AZZAM BOY 21-10-2010 INDONESIA
    AZZAM
    MOCH FAHRI
    10 SUDRAJAT WILDANI PUTRA BOY 04-04-2009 INDONESIA
    SUDRAJAT
    KEIRA PUTRI
    11 INDRIAN GIRL 06-03-2008 INDONESIA
    INDRIAN
    12 RIJALUDIN WAN RIJALUDIN BOY 23-01-2007 INDONESIA

    Kindly return the duly completed registration form to PBSI Jawa Barat by email to pbsijawabarat2018@gmail.com by 8
    June, 2019.

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