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    Biodata-PPG-2024

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    agusputra22
    YAYAYA

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    Biodata-PPG-2024

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    YAYAYA

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    YAYAYA

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    Download as docx, pdf, or txt
    1 views2 pages

    Biodata-PPG-2024

    Uploaded by

    agusputra22
    YAYAYA

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
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    BIODATA MAHASISWA

    PPG GURU TERTENTU TAHUN 2024


    UNIVERSITAS ISLAM MALANG
    SESUAI FORMAT PANGKALAN DATA PERGURUAN TINGGI
    (PD-DIKTI)

    Nama* : SUSAN AMELIA, S.Pd


    ………………………………………………………………………………………
    Tempat Lahir* : CIMAHI
    ………………………………………………………………………………………
    Jenis Kelamin : Laki-laki Perempuan

    Nama Ibu* : SUSI MEILAWATI


    ………………………………………………………………………………………
    Tanggal lahir* : 4 JUNI 1998
    ………………………………………………………………………………………
    Agama* : ISLAM
    ………………………………………………………………………………………
    Kewarganegaraan* : WNI
    ………………………………………………………………………………………
    NIK* : 3217064406980001
    ………………………………………………………………………………………
    NISN :-
    ………………………………………………………………………………………
    NPWP :-
    ………………………………………………………………………………………

    Alamat

    Jalan : KP. CIBURIAL NO. 172


    ………………………………………………………………………………………
    Dusun : ……………….……………………………………………… RT: 04… RW: 12...

    Kelurahan* : MARGAJAYA…………………………………………… Kode Pos: 40552……

    Kecamatan* :NGAMPRAH
    ………………………………………………………………………………………
    Jenis Tinggal : RUMAH
    ………………………………………………………………………………………
    Alat Transportasi : MOTOR
    ………………………………………………………………………………………

    Telepon :
    ………………………………………………………………………………………
    HP : 082117193100
    ………………………………………………………………………………………
    PenerimaKPS* : Ya / Tidak

    No.KPS :-
    ………………………………………………………………………………………
    Orang Tua

    Ayah

    NIK : 3217061702730003
    ………………………………………………………………………………………
    Nama : IWAN SETIAWAN
    ………………………………………………………………………………………
    Tanggal Lahir : 17 FEBRUARI 1973
    ………………………………………………………………………………………
    Pendidikan : SMA
    ………………………………………………………………………………………
    Pekerjaan :-
    ………………………………………………………………………………………
    Penghasilan :0
    ………………………………………………………………………………………
    Ibu

    NIK : 3217064505760025
    ………………………………………………………………………………………
    Nama : SUSI MEILAWATI
    ………………………………………………………………………………………
    Tanggal Lahir : 5 MEI 1976
    ………………………………………………………………………………………
    Pendidikan : SMA
    ………………………………………………………………………………………
    Pekerjaan : IBU RUMAH TANGGA
    ………………………………………………………………………………………
    Penghasilan :0
    ………………………………………………………………………………………

    Bandung Barat, 19 September 2024


    Foto berwarna
    3x4

    SUSAN AMELIA, S.Pd


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

    *) WAJIB DIISI

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