Daftar Riwayat Hidup Peserta Diskusi Andministrasi Negara

HIMPUNAN MAHASISWA JURUSAN ILMU ADMINISTRAS NEGARA

UNIVERSITAS JENDERAL SOEDIRMAN

PURWOKERTO

BIDANG PENALARAN

Daftar Riwayat Hidup Peserta Diskusi Andministrasi Negara

Nama Lengkap                  :  ____________________________________________________________

Nama Panggilan                :  ____________________________________________________________

Jenis Kelamin                    :  Pria / Wanita (Coret yang tidak perlu)

Tempat, tanggal lahir         :  ____________________________________________________________

Agama                               :  ____________________________________________________________

Suku                                  :  ____________________________________________________________

Alamat/Kode Pos              :  ____________________________________________________________

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Riwayat Pendidikan          :  (Nama Sekolah, Lamanya pendidikan)

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Prestasi                              :  ____________________________________________________________

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Pengalaman Organisasi      :  (Nama Organisasi, Jabatan, Tahun)

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Motto Hidup                     :  ____________________________________________________________

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Nomor Telepon                  :  +  62

4X6 Warna ½ Badan

Purwokerto, ..................................................................

Daftar riwayat hidup ini saya buat dengan sebenar-benarnya.

Tanda Tangan

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NIM.