FORMULIR PENDAFTARAN CALON PENGURUS
BADAN EKSEKUTIF MAHASISWA 2014/2015
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- Nama Lengkap : ............................................................
- Nama Panggilan : ............................................................
- Prodi/Angkatan : ............................................................
- Kelas : ............................................................
- NPM : ......................................................................................
- Tempat Tanggal Lahir : ......................................................................................
- Jenis Kelamin : ......................................................................................
- Agama : .......................................................................................
- Alamat Asal : .......................................................................................
- Alamat Sekarang : ....................................................................................... .........................................................................................................................................
- No.Tlp/HP : .......................................................................................
- E-mail/FB/Twitter : ....................................................................................... .........................................................................................................................................
- IPK Terakhir : .......................................................................................
- Hobi : .......................................................................................
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- Moto Hidup : .......................................................................................
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- Keahlian Yang Dimiliki : .......................................................................................
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17. Riwayat Pendidikan.
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NO
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PENDIDIKAN
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ALAMAT
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TAHUN LULUS
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1.
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SD/MI
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2.
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SMP/MTS
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3.
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SMA/SMK/MA
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- Pengalaman Organisasi.
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No
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Organisasi
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Jabatan
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Periode
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1.
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2.
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|||
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3.
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|||
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4.
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|||
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5.
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|||
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6.
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- Pengalaman Kepanitiaan.
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No
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Kepanitiaan
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Jabatan
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Tahun
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1.
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|||
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2.
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|||
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3.
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4.
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|||
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5.
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- Prestasi Yang Pernah Diraih : .......................................................................................
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  Laptop |
Motor/Mobil |
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Kamera Digital
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Lainnya……
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- Fasilitas Yang Dimiliki.
- Motivasi Masuk BEM FE-UNMURA : ...............................................................
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- Harapan Untuk BEM FE-UNMURA : ................................................................
..........................................................................................................................................
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- Usulan Program Untuk BEM FE-UNMURA : ...............................................................
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Lubuklinggau, November 2014
Pendaftar
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