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FORMULIR PENDAFTARAN MAHASISWA BARU
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Email
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NIK : 3273292709940002
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FAJAR PRANATA HIDAYAT
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i
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TEMPAT LAHIR : BANDUNG
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Tanggal Lahir : 27 SEPTEMBER 1994
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MM
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DD
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YYYY
Agama
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Islam
Kristen Protestan
Katolik
Hindu
Buddha
Kong Hu Cu
Lainnya.
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Email:
fajarpranata1212@gmail.com
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Nomor HP :081931370171 / 085722368829
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Asal SLTA/Kampus: SMA N 10 PURWOREJO
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Asal Jurusan : IPS
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NISN
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NPSN
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Nama Ayah : SUDARSO
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WIRASWASTA
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NO HP ; 081321151161
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Pekerjaan Orang Tua
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Nomor Telepon
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Alamat Rumah Orang Tua
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