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AUTOMOTIVE SKILL COMPETITION (ASC) 2017 TINGKAT SMK SE-JAWA TENGAH JURUSAN TEKNIK MESIN FAKULTAS TEKNIK UNIVERSITAS NEGERI SEMARANG 2017 FORMULIR PENDAFTARAN Yang bertandatangan dibawah ini, Ketua Jurusan................................................... SMK............................................................. menerangkan bahwa, Nama : ............................................................ .................................................... Tempat/Tanggal Lahir : ............................................................ .................................................... NIS : .................................................. .............................................................. Kelas : .................................................. .............................................................. Jurusan : ............................................................ .................................................... Sekolah : ............................................................ .................................................... No. Handphone : ............................................................ .................................................... Dengan ini menyatakan bahwa siswa tersebut benar-benar siswa SMK........................................................ *Formulir dapat diperbanyak sendiri

Transcript of himpromesin.ukm.unnes.ac.idhimpromesin.ukm.unnes.ac.id/wp-content/uploads/2017/08/... · Web...

Page 1: himpromesin.ukm.unnes.ac.idhimpromesin.ukm.unnes.ac.id/wp-content/uploads/2017/08/... · Web viewUNIVERSITAS NEGERI SEMARANG Author Novar Bayu Tambrani Created Date 07/30/2017 10:33:00

AUTOMOTIVE SKILL COMPETITION (ASC) 2017

TINGKAT SMK SE-JAWA TENGAH

JURUSAN TEKNIK MESIN FAKULTAS TEKNIK

UNIVERSITAS NEGERI SEMARANG

2017

FORMULIR PENDAFTARAN

Yang bertandatangan dibawah ini,

Ketua Jurusan...................................................................................................................................

SMK.................................................................................................................................................

menerangkan bahwa,

Nama : ................................................................................................................

Tempat/Tanggal Lahir : ................................................................................................................

NIS : ................................................................................................................

Kelas : ................................................................................................................

Jurusan : ................................................................................................................

Sekolah : ................................................................................................................

No. Handphone : ................................................................................................................

Dengan ini menyatakan bahwa siswa tersebut benar-benar siswa SMK........................................................ Kelas....................... Jurusan.............................................

Mengetahui,

Ketua Jurusan Peserta

(.................................................) (.........................................)

NIP. NIS.

*Formulir dapat diperbanyak sendiri

FOTO PESERTA

3 X 4

(BERWARNA)