DATA PRAKERIN

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DATA PRAKERIN

Isilah dengan data yang sebenarnya untuk memudahkan dalam proses berikutnya

* Indicates required question

Nama Lengkap (GUNAKAN HURUF KAPITAL) *

Your answer

Tempat, Tanggal Lahir *

Your answer

Jenis Kelamin *

Choose

Laki-laki

Perempuan

JURUSAN *

Choose

TBSM

TKJ

BDP

No Kontak/HP *

Your answer

FB/IG/WA *

Your answer

Alamat lengkap (Kp/jalan, No Rumah, RT/RW, Kelurahan/desa, kec,) *

Your answer

Nama Ayah *

Your answer

Kontak Ayah *

Your answer

Alamat Ayah *

Your answer

Nama Ibu *

Your answer

Kontak Ibu *

Your answer

Alamat Ibu *

Your answer

Submit

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