7/26/2019 Formulir Pendaftaran Khitanan Massal 2016 AQILA

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PANITIA PENYELENGGARA KHITANAN MASSALAQILA ISLAMIC SCHOOL

 Jl. Kapten Muslim No.265 Helvetia – Medan 20124 Telp. 061 8002 1188

Formulir PendaftaranNomor : ...!"

Formulir Kitanan Ma!!al "#$%

I& Identita! Oran' Tuaa. Nama : ................................................................#. $lamat : ................................................................

%. &e'er(aan : ................................................................

d. Telepon )* #isa di+u#un*i :......................................................

II& Identita! Ana( a. Nama : ................................................................#. $lamat : ................................................................

%. $sal ,e'ola+ : ................................................................d. -mur : ................................................................

 

Per!)aratan1. &endataran mulai Tan**al 20 $pril s.d 1 Mei 2016 setiap +ari 'er(a2. /ormulir pendataran di'em#ali'an palin* lam#at Tan**al 1 Mei 2016 pada

&u'ul 14.00 3. /oto op) KT& ran* Tua4. /oto op) Kartu Keluar*a KK"5. /oto op) $'ta Kela+iran ana'6. &eserta K+itanan Massal ter#atas dan &anitia #er+a' menola' (i'a pendatar

suda+ sesuai tar*et.7. &ela'sanaan K+itanan Massal in s)a9 $lla+ a'an dila'sana'an pada +ari

!a*tu+  ", Mei "#$%  di edun* se'ola+ $;<$ =-M$H >=M$N Jln.Kapten Muslim No.275 &u'ul 08.00. i# s.d ,elesai.

&anitia

......................................"Nama Jelas

Medan ????????????? 2016

ran* Tua@alimen*iAin'an ana' untu' di'+itan

......................................"Nama Jelas