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FORMULIR PENDAFTARAN KULIAH KERJA NYATA (KKN) TAHUN AKADEMIK 2020/2021
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Kode PTAIS/ Fakultas
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Jurusan*
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Pendidikan Agama Islam (PAI)
Manajemen pendidikan Islam (MPI)
NIM/ NPM
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NIMKO/ NIRM
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Nama Lengkap
*
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Jenis Kelamin
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Laki-laki
Perempuan
Tempat Tanggal Lahir
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Status Sipil
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Belum Menikah
Menikah
Janda
Duda
Pekerjaan
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Alamat lengkap
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Domisili Selama Kuliah
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Pondok UW
Ikut Orang Tua
Kost
Rumah Sendiri
Non Pondok UW
Tanggal Pendaftaran
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