Formulir PPDB 21-22

 

CBKDGLG VBIMOMOEGI KG‟GTON IR EBIMGC

XKV IR 6? TA\AXGTO @c. Dgjgro Dgrgt Lbkpacsbwu Ebh. Tawasgro Ebimgc 2782= ]bcp. 64?=-> 64?=->=48== =48==

NATKRCOT VBIBTOKGGI VBXBT]G MOMOE DGTR ]GJRI VBCG@GTGI 4647/4644 G. EB]B EB]BTGIL TGILGI GI HGCAI HGCAI VBXBT]G VBXBT]G MOMOE MOMOE 7.

Igkg Cbilegp

0

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

4.

IOE/ Iakar Oimue Ebcugrlg

0

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

8.

@bios Ebcgkoi

0 ( Cgeo-cgeo / Vbrbkpugi )*.

=.

IOXI / Iakar Oimue Xoswg Igsoaigc Igsoaigc 0

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

2.

]bkpgt, ]lc. Dci. ]ji. Cgjor

0

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

>.

Glgkg

0

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

gileg).

 (76 gileg).

.............................................  T]. ...........  T\. ............  Ms. .............................

  Ebh. ........................................................  Egd. ................................................. 76. Ia. ]bcp. / Jp. ygil dosg mojud mojuduilo uilo 0

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

77. Gcukio mgro XM / KO Gsgc

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

0

74. @ukcgj Iocgo Gejor mgi Iocgo Tgtg-rgtg   0 @ukcgj IG ; ..........................,  Iocgo Tgtg-rgtg ; .................................

D. EB]B EB]BTGIL TGILGI GI ATGIL ATGIL ] ]RG RG EG EGIMRI IMRIL L 7.

Igkg Igkg Cb Cbile ilegp gp

4.

g. Gygj Gygj

0

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

d. Odu

0

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

g. Gygj Gygj

0

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

d. Od Odu u

0

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

g. Gygj Gygj

0

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

d. Od Odu u

0

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

]bkpgt, ]bkpgt, ]lc. Dci. ]ji. Cgjor

8. Vbebr` Vbebr`ggi ggi

=. Gcgkgt ]bkpgt ]oillgc

0 @ci. ...................................  T]. .........  T\. ......... Ms. ................................... Ebh. ....................................................  Egd. ....................................................

H. EB] EB]BTG BTGIL ILGI GI \GCO \GCO 7. Igkg Cbilegp

0

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

4.

@bios Ebcgkoi

0 ( Cgeo-cgeo / Vbrbkpugi )*.

8.

]bkpgt, ]lc. Dci. ]ji. Cgjor

0

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

=.

Glgkg

0

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

2.

Vbebr`ggi

0

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

0

.............................................  T]. ........ T\. ........ Ms. ...................................

  Gcgkgt ]bkpgt ]oillgc

Ebh. .....................................................  Egd. .................................................... >.

 

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