NamaNomor UKGBidang Studi PPGMatematikaFisikaEkonomiBahasa IndonesiaBahasa InggrisTempat Lahir Sesuai IjazahTanggal Lahir Sesuai IjazahJenis KelaminLaki-lakiPerempuanNama Ibu KandungAgamaIslamKristen ProtestanKristen KatolikHinduBudhaKonghucuAsal Perguruan Tinggi S1IPK S1NIKNPWPJalanDusunRTRWKelurahanKecamatanKabupaten /KotaKode PosNomor HPEmailPakta Integritas (Format diunduh dari SIMPKB)Choose FileNo file chosenDelete uploaded fileScan Surat Pernyataan Izin Kepala SekolahChoose FileNo file chosenDelete uploaded fileScan Format A1 (Format diunduh dari SIMKB)Choose FileNo file chosenDelete uploaded fileScan Ijazah S1Choose FileNo file chosenDelete uploaded fileScan Transkrip Nilai S1Choose FileNo file chosenDelete uploaded fileScan Kartu Identitas KTP/SIMChoose FileNo file chosenDelete uploaded fileScan NPWPChoose FileNo file chosenDelete uploaded fileScan SK Kepegawaian TerakhirChoose FileNo file chosenDelete uploaded fileScan Foto Berwarna dimensi 4 x 6Choose FileNo file chosenDelete uploaded fileScan SKCK (dari Kepolisian setempat)Choose FileNo file chosenDelete uploaded fileScan Surat Keterangan Sehat (dari RSU setempat)Choose FileNo file chosenDelete uploaded fileScan Surat Bebas NAPZA (dari BNN/Kepolisian/RSU)Choose FileNo file chosenDelete uploaded fileUnggah BiodataChoose FileNo file chosenDelete uploaded fileKirim
