formulir gea berkurban
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FORMULIR PESERTA GEA BERKURBAN 1436 H
QURBAN ATAS NAMA
1. ........................................... bin .........................
2. ........................................... bin .........................
3. ........................................... bin .........................
4. ........................................... bin .........................
5. ........................................... bin .........................
6. ........................................... bin .........................
7. ........................................... bin .........................
NO. HP/TELP
TIPE HEWAN QURBAN (KAMBING)
Type A (21-23 kg) Rp 1.750.000 □ ........ ekor
Type B (24-25 kg) Rp 1.900.000 □ ........ ekor
Type C (26-28 kg) Rp 2.100.000 □ ........ ekor
Type D (29-31 kg) Rp 2.300.000 □ ........ ekor
Super (33-37 kg) Rp 2.500.000 - Rp 2.850.000 □ ........ ekor
Istimewa (38-43 kg) Rp 3.000.000 - Rp 3.500.000 □ ........ ekor
Spesial (45-70 kg) Rp 3.600.000 - Rp 4.500.000 □ ........ ekor
PEMBAYARAN
□ Cash
□ Transfer (Bank..............................................)
TANGGAL ............................................... 2015
TANDA TANGAN
NAMA JELAS
FORMULIR PESERTA GEA BERKURBAN 1436 H
QURBAN ATAS NAMA
1. ........................................... bin .........................
2. ........................................... bin .........................
3. ........................................... bin .........................
4. ........................................... bin .........................
5. ........................................... bin .........................
6. ........................................... bin .........................
7. ........................................... bin .........................
NO. HP/TELP
TIPE HEWAN QURBAN (SAPI)
Type A (200-230 kg) Rp 14.000.000 □ ........ ekor
Type B (240-260 kg) Rp 15.500.000 □ ........ ekor
Type C (270-290 kg) Rp 16.750.000 □ ........ ekor
Type D (300-330 kg) Rp 18.000.000 □ ........ ekor
Super (350-409 kg) Rp 19.000.000 - Rp 24.000.000
□ ........ ekor
PEMBAYARAN□ Cash
□ Transfer (Bank..............................................)
TANGGAL ............................................... 2015
TANDA TANGAN
NAMA JELAS
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