Form Pengiriman Sampah Elektronik
Form ini digunakan bagi kalian yang akan mengirimkan sampah elektronik ke Bank Sampah Bersinar
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Tanggal Pengiriman *
MM
/
DD
/
YYYY
Nama *
Usia *
Nomor HP/WA *
Email *
Kecamatan dan Kota Tinggal *
Akun Instagram *
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