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Lomba Menulis Kisah Relawan Kategori Mahasiswa
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Nama
*
Your answer
Jenis Kelamin
*
laki-laki
perempuan
Nomor KTP/SIM
*
Your answer
Tempat Lahir
*
Your answer
Tanggal Lahir
*
MM
/
DD
/
YYYY
Alamat Rumah
*
Your answer
Nomor Registrasi Mahasiswa/NIM
*
Your answer
Nama Kampus
*
Your answer
Jurusan
*
Your answer
No. Tlp/HP
*
Your answer
Email
*
Your answer
Facebook
*
contoh :
https://www.facebook.com/presidenkujokowidodo
Your answer
Twitter
contoh : @PresidenkuJKW
Your answer
Nama kontak tokoh/narasumber
*
Your answer
Alamat kontak tokoh/narasumber
*
Your answer
Judul Karya Tulis
*
Your answer
Karya Tulis
*
Your answer
Saya mengakui bahwa tulisan ini berdasarkan fakta dan benar-benar buatan saya sendiri. Jika dikemudian hari saya terbukti melanggar UU Hak Cipta, saya siap digugat melalui jalur hukum.
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