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Resitration Form

This document outlines the registration requirements for foreign students, including personal information, choices of study programs, previous education, and family details. It specifies the need for supporting documents such as diplomas and identification cards, along with a registration fee of RP. 200.000. Additionally, contact information is provided for further inquiries.

Uploaded by

Muhammad Arian toni
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40 views1 page

Resitration Form

This document outlines the registration requirements for foreign students, including personal information, choices of study programs, previous education, and family details. It specifies the need for supporting documents such as diplomas and identification cards, along with a registration fee of RP. 200.000. Additionally, contact information is provided for further inquiries.

Uploaded by

Muhammad Arian toni
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

REGULATION FOR FOREIGN STUDENTS REGISTRATION

FULL NAME :
ID NUMBER :
GENDER : Man Woman
RELEGION :
PLACE OF BIRTH :
DATE OF BIRTH :
MARRIAGE STATUS : Single Married Ever Married
ADDRESS
PROVINCE :
CITY / REGENCY :
SUBDISTRICT :
STREET :
RT :
SUBDISTRICT :
POSTAL CODE :
TELEPHONE NUMBER :
EMAIL : May write with lowercase
HANDPHONE :
PLACE TO LIFE WHILE STUDYING : Rent Own House Family House

CHOICES OF STUDY PROGRAM


FIRST : Management Economic Development Accounting
SECOND : Management Economic Development Accounting

PREVIOUS EDUCATION
PROVINCE :
REGENCY /CITY :
SCHOOL NAME :
SCHOOL ADDRESS :
SCHOOL MAJOR :
AVERAGE VALUE (SENIOR HIGH SCHOOL) :
GPA :
YEAR OF DIPLOMA :
SCHOOL ENTERING YEAR :
FAMILY
NUMBERS OF SIBLINGS : BROTHER SISTER
FATHER NAME :
FATHER JOB :
FATHER'S LAST EDUCATION :
FATHER'S INCOME : 0-500.000 500.000-1.000.000 1.000.001-2.000.000 2.000.001-5.000.000 ≥ 5.000.000
MOTHER NAME :
MOTHER JOB :
PENDIDIKAN TERAKHIR
MOTHER'S LAST IBU
EDUCATION :
MOTHER'S INCOME : 0-500.000 500.000-1.000.000 1.000.001-2.000.000 2.000.001-5.000.000 ≥ 5.000.000

BY ATTACHING .............................................., - -20


FOTOCOPY OF DIPLOMA
FOTOCOPY OF FAMILY CARD Dan ID CARD
REGISTRATION FEE FOR REGULER STUDENT RP. 200.000 Foto
FOR MORE INFORMATION CALL PHONE/WA: 0811744284 3x4

............................................................................

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