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Form Pendaftaran Peserta Khitanan Massal, Agustus-2020.
Khitanan massal ini di selenggarakan oleh KMII JEPANG dan IPMI JEPANG yang bekerja sama dengan Kawasaki Chuo Clinic
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* Indicates required question
Email
*
Your email
Nama Peserta (氏名)
*
Your answer
Umur (年)
*
Your answer
Nama Orang Tua (親名)
*
Your answer
Alamat (住所)
*
Your answer
No Hp/Telp (電話番号)
*
Your answer
Email (メールアドレス)
*
Your answer
Tanggal Permohonan Khitanan (割礼希望の日)
*
Tgl 09 Agustus (09日8月)
Tgl 10 Agustus (10日8月)
Tgl 14 Agustus (14日8月)
Tgl 22 Agustus (22日8月)
Tgl 23 Agustus (23日8月)
その他
Other:
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