FORMULIR PENDAFTARAN ANGGOTA UKM MAFATERNA
FORMULIR PENDAFTARAN ANGGOTA
LEMBAGA PERS MAHASISWA MAFATERNA
FAKULTAS PETERNAKAN
UNIVERSITAS BRAWIJAYA
NAMA
: .........................................................................................................
NIM
: .........................................................................................................
TTL
: .........................................................................................................
FOTO
3X 4
ALAMAT
ASAL : ........................................................................................................
KOS
: ........................................................................................................
JENIS KELAMIN : ...................................................................................................
AGAMA
: .........................................................................................................
NO. HP / ID LINE : ....................................................................................................
HOBBY
: .........................................................................................................
MINAT
:
Jurnalistik
Photography
Kepenulisan
Illustrator
Design
Layout
APA YANG KAMU TAHU TENTANG LPM MAFATERNA
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MOTIVASI BERGABUNG DENGAN LPM MAFATERNA
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ORGANISASI YANG PERNAH DIIKUTI
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LEMBAGA PERS MAHASISWA MAFATERNA
FAKULTAS PETERNAKAN
UNIVERSITAS BRAWIJAYA
NAMA
: .........................................................................................................
NIM
: .........................................................................................................
TTL
: .........................................................................................................
FOTO
3X 4
ALAMAT
ASAL : ........................................................................................................
KOS
: ........................................................................................................
JENIS KELAMIN : ...................................................................................................
AGAMA
: .........................................................................................................
NO. HP / ID LINE : ....................................................................................................
HOBBY
: .........................................................................................................
MINAT
:
Jurnalistik
Photography
Kepenulisan
Illustrator
Design
Layout
APA YANG KAMU TAHU TENTANG LPM MAFATERNA
....................................................................................................................................................................................
....................................................................................................................................................................................
....................................................................................................................................................................................
....................................................................................................................................................................................
MOTIVASI BERGABUNG DENGAN LPM MAFATERNA
....................................................................................................................................................................................
....................................................................................................................................................................................
....................................................................................................................................................................................
....................................................................................................................................................................................
ORGANISASI YANG PERNAH DIIKUTI
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