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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........................................................ Kelas....................... Jurusan.............................................
Mengetahui,
Ketua Jurusan Peserta
(.................................................) (.........................................)
NIP. NIS.
*Formulir dapat diperbanyak sendiri
FOTO PESERTA
3 X 4
(BERWARNA)