No.

PANITIA PELAKSANA
OPEN RECRUITMENT & LEADERSHIP TRAINING
UNIT KEGIATAN MAHASISWA (UKM) BAHASA
POLITEKNIK NEGERI UJUNG PANDANG
Sekretariat: PKM Politeknik Negeri Ujung Pandang
Jln. Perintis Kemerdekaan Km. 10 Tamalanrea Makassar 90245
Telp: 081 243 311 336 Email: pnupukmbahasa@gmail.com

REGISTRATION FORM

FULL NAME :
NICK NAME :
LEDGER (STAMBUK) :
DEPARTEMENT :
PLACE AND DATE OF BIRTH :
SEX :
RELIGION :
PHONE NUMBER :
HOBBY :
ADDRESS IN MAKASSAR :
REGIONAL FROM :
SCHOOL ORIGION :
EDUCATION BACKGROUND :
1.
2.
3.
ORGANIZATION EXPERIENCE :
1.
2.
3.
LINGUISTIC ACTIVITIES HAVE BEEN FOLLOWED :
TRAINING :

COURSE :

CONTEST :

MAKASSAR, 2024
Pas Foto
3x4
Latar Biru
Tua

Nb :
 Use English and capital letters
 Register form must be typed using times new roman font 11 and convert to pdf
 Taking form fee is Rp30.000,-
 Down payment (DP) is at least Rp20.000,-
 Returning form period end on February 14th 2024
 For more information, contact us via WA 081 343 430 599, http://ukmbahasa.poliupg.ac.id
 PANITIA PELAKSANA
OPEN RECRUITMENT & LEADERSHIP TRAINING
UNIT KEGIATAN MAHASISWA (UKM) BAHASA
POLITEKNIK NEGERI UJUNG PANDANG
Sekretariat: PKM Politeknik Negeri Ujung Pandang
Jln. Perintis Kemerdekaan Km. 10 Tamalanrea Makassar 90245
Telp: 081 243 311 336 Email: pnupukmbahasa@gmail.com

or in Secretariat of UKM Bahasa Politeknik Negeri Ujung Pandang