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Formulir Registrasi Peserta Uji Kompetensi 2023
Calon peserta Bimbingan Teknis dan Uji Kompetensi Kultur Jaringan harap mengisi data sesuai KTP
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Nama Lengkap
*
Your answer
NIK (Nomor Induk Kependudukan)
*
Your answer
Tempat Lahir (Kabupaten/ Kota)
*
Your answer
Tanggal Lahir
*
MM
/
DD
/
YYYY
Jenis Kelamin
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Laki laki
Perempuan
Tempat Tinggal (alamat sesuai data KTP)
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Your answer
Kabupaten/ Kota
*
Your answer
Provinsi
*
Your answer
No. Telepon (WhatsApp)
*
Your answer
Email
*
Tuliskan alamat email anda yang aktif
Your answer
NIM/ NIP/ NRP
*
Your answer
Instansi
*
Contoh format: Jurusan, Fakultas, Universitas
Your answer
Alamat Tinggal Sementara
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Jika tidak ada, tuliskan angka "0"
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