FORMULIR BIODATA IPMI SIDRAP CAB. TELLU LIMPOE PERIODE 2008-2009

Bagi teman-teman IPMI SIDRAP CABANG TELLU LIMPOE diharapkan mengirimkan biodata lengkapnya ke email: ipmitellulimpoe@gmail.com dengan mengisi formulir berikut ini:

Nama Lengkap:.........................................................................................................

Nama Panggilan:.......................................................................................................

Tetala:.......................................................................................................................

Alamat di maksassar:...................................................................................

Agama:..............................................................................................................

No. HP:..............................................................................................................

Email :................................................................................................................

webblog :...........................................................................................................

Universitas :......................................................................................................

Fakultas :...........................................................................................................

Jurusan: ............................................................................................................

Prinsip :..............................................................................................................

Hobby :..............................................................................................................

Anak Ke :...........................................................................................................

Nama Orang Tua:

1. Ayah:.............................................................................................................

2. Ibu :...............................................................................................................

Alamat Orang tua:

1. Ayah :.............................................................................................................

2. Ibu:................................................................................................................

Pesan:..................................................................................................................