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| "BINA KARYA
COM" |
| Alamat : Jln. Raya
Bajang - Mlarak Ponorogo / Utara Perempatan Jabung |
| Telp. (0352)
312571. HP. 082143777483 – 0852 307 577 00 . E. Mail.
Syahrudin.mahakarya14@gmail.com |
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| FORMULIR
PENDAFTARAN TAHUN 2016 |
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| Nama |
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Gelar Depan |
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Gelar Belakang |
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| Pendidikan Terakhir |
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SD |
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SLTP |
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SLTA |
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D 1 |
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D 2 |
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D 3 |
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S 1 |
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| Jenis Kelamin |
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Laki - Laki |
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Perempuan |
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Tgl |
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Bulan |
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Tahun |
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| Tempat/Tgl Lahir |
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| Agama |
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Islam |
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Kristen |
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Katholik |
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Hindu |
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Budha |
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| Alamat Rumah |
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Jalan |
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| Desa |
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| Kecamatan |
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| Kabupaten |
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| Propinsi |
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| Kode Pos |
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Tlp. |
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Hp. |
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| Materi / Program Kursus |
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MICROSOFT WORD, |
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MEMBUAT EMAIL |
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MICROSOFT EXCEL , |
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MEMBUAT BLOG |
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MICROSOFT POWER POINT. |
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Web |
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| Hari Dan
Waktu Kursus |
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SELASA - JUM`AT |
13.00-15.00 |
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| Ibu |
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......................................... Pekerjaan : ........................ |
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| Ayah |
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......................................... Pekerjaan : ........................ |
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| Alamat: |
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……………………………………………………………………………………………………… |
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| Telp. Rumah |
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……………………………………………………………………………………………………… |
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| Dengan ini saya menyatakan bahwa informasi yang saya tuliskan
diatas adalah benar. Dan saya bersedia mengikuti kursus ini dengan
sebaik-baiknya. |
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KETENTUAN ADMINISTRASI KEUANGAN DAN FASILITAS |
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1 |
Biaya pendaftaran Rp.25.000 |
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Fasilitas : |
1 |
BUKU PANDUAN/MODUL |
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2 |
Buku dan alat tulis Dan
Stiker |
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3 |
Layar LCD Proyektor |
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4 |
Pemateri |
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5 |
Pembayaran Bisa Diangsur Selama Pendidikan
Berlangsung. |
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6 |
Lama Pendidikan 9 kali
pertemuan |
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7 |
Biaya paket Kursus Rp 500.000 |
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| NB.
Untuk Wilayah Kota Bertempat di GMC Depan Kantor PLN |
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Ponorogo, ……………………………………….. |
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| Diterima oleh |
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| (………………………………….) |
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(………………………………….) |
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| Sekretaris |
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Pendaftar |
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