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FORMULIR PENDAFTARAN CALON PESERTA PELATIHAN PT.ERRENA MITRA KELUARGA
International Job Placement Form 100%
* Indicates required question
Email
*
Your email
TANGGAL PENDAFTARAN
*
MM
/
DD
/
YYYY
Interested Program
*
NURSE
MANUFACTURE
AGRICULTURE
HOSPITALITY
CLEANING MANAGEMENT
Other:
DESTINY
*
Program SSW JEPANG
Other:
Nama (sesuai ijazah terakhir)
*
Your answer
Alamat(Lengkap)
*
Your answer
Nomor Whats Up/Telegram
*
Your answer
Tempat,Tanggal Lahir
*
Your answer
Jenis Kelamin
Laki - Laki
Perempuan
Clear selection
Status
*
Belum Menikah
Menikah
Agama
*
Islam
Katolik
Protestan
Budha
Hindu
Konghucu
Golongan Darah
*
A
B
AB
O
Nama Sekolah (SMA/SMK) / Perguruan Tinggi
*
Your answer
Kota Asal Sekolah / Perguruan Tinggi
*
Your answer
Jurusan di Sekolah
*
SMK
IPA
IPS
BAHASA
Perguruan Tinggi
*
Your answer
Tahun Lulusan
*
Your answer
Nama Ayah
*
Your answer
Nama Ibu
*
Your answer
Email Orang Tua ( tulis salah satu saja)
*
Your answer
Nomor Telepon Orang Tua ( Tulis salah satu saja )
*
Your answer
Pekerjaan Orang Tua
*
PNS/BUMN
Pegawai Swasta
Wiraswasta
Dokter
TNI/POLRI
Other:
Penghasilan Orang Tua
*
Rp.1.000.000 - Rp.3.000.000
Rp.3.000.000 - Rp.5.000.000
Rp.5.000.000 - Rp.7.000.000
Diatas Rp.7.000.000
MENGETAHUI ERRENA DARI
*
INSTAGRAM
FACEBOOK
TEMAN/RELASI
WEBSITE
Other:
Ukuran Kaos
*
S
M
L
XL
XXL
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