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PANITIA PELAKSANA

PANITIA PELAKSANA
LATIHAN KADER MUDA
PAC IPNU – IPPNU LATIHAN KADER MUDA
KECAMATAN PANCENG PAC IPNU – IPPNU
Sekretariat: Kantor MWC NU Panceng RT/RW 04/02 Banyutengah Panceng Gresik Kode Pos: 61156 No. Hp: 085851877155 – 085706146959 KECAMATAN PANCENG
Sekretariat: Kantor MWC NU Panceng RT/RW 04/02 Banyutengah Panceng Gresik Kode Pos: 61156 No. Hp: 085851877155 – 085706146959

SURAT PERMOHONAN MENGIKUTI LAKMUD


Kepada Yth :
Ketua Panitia LAKMUD ANGKET SELEKSI PESERTA LAKMUD
Di.
Tempat Nama : ……………………………………………………………………
Assalamu’alaikum Warohmatullahi Wabarokatuh TTL : ……………………………………………………………………
Bismillahirrahmanirrahim Alamat : ……………………………………………………………………
Sehubungan dengan diselenggarakannya Latihan Kader Muda (LAKMUD) PAC. No.hp : ……………………………………………………………………
IPNU-IPPNU Kecamatan Panceng, maka dengan ini saya :
Email : ……………………………………………………………………
Nama : jjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjj,jjjjj
Tempat, tgl. Lahir : jjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjj 1. Kapan Rekan /Rekanita bergabung IPNU/IPPNU? Tahun ………………
Alamat rumah : jjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjj
Anggota Ranting/Komisariat : jjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjj
2. Apa alasan rekan/rekanita menjadi Anggota IPNU/IPPNU ?
Menyatakan kesediaan menjadi peserta Latihan Kader Muda (LAKMUD) IPNU-IPPNU
Anak Cabang Kecamatan Panceng. Dan sebagaimana persyaratan yang telah ………………………………………………………………………………
ditentukan, bersama ini saya lampirkan :
1. Biodata Peserta 3. Jabatan Apa yang rekan/rekanita emban di Ranting/Komisariat ?
2. Foto 3x4 berwarna 3 lembar .............................................................................................................
3.Foto copy Piagam/Sertifikat MAKESTA /surat mandat/surat keterangan aktif
organisasi (*coret yang tidak sesuai)
4. Angket seleksi peserta 4. Apa pendapat rekan/rekanita tentang LAKMUD ?
Demikian Permohonan saya, atas perhatiannya disampaikan terima kasih. ………………….......................……………………………………………

Wallahul Muwafiq ila Aqwamit Thariq


Wassalamu’alaikum Warohmatullahi Wabarokatuh 5. Apa motivasi rekan/rekanita mengikuti LAKMUD ?
Kkkkkkkkkk, jaja jajjaajajjajajajaja2016 ………………………………………………………………………………

Hormat saya 6. Bersediakah rekan/rekanita mengikuti LAKMUD dengan penuh


tanggungjawab dan loyalitas tinggi?
ABDULLAH CHARIFhhhh ..........................................................................................................

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