Pendaftaran

PENDAFTARAN MAHASISWA BARU

Subject/Jurusan

Name/Nama

Address/Tempat Lahir*

Date/Tanggal Lahir*

Gender/Jenis Kelamin

Religion/Agama

Nationality/Kewarganegaraan

Address/Alamat*

City/Kota

Province/Provinsi

ID Number/NIK

Your mother's name/Nama Ibu Kandung*

Telepon/Tlp

Handphone/Hp*

Email

Bank transfer/Nama Bank Transfer*

Date Transfer/Tanggal Transfer*

Scan Bukti Pembayaran*

PHOTO 4 X 6*

Scan KTP*

Scan KK*

Message/Pesan*