Form SURAT PENGAJUAN BEASISWA LAZISMU [PDF]

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Perihal



: Pengajuan Beasiswa



Kepada : Yth.Pimpinan Lazismu Jawa Barat Di Tempat



Assalamu’alaikum Wr. Wb. Yang bertanda tangan di bawah ini : Nama



: ................................................................................................



Tempat, Tanggal, Lahir : ................................................................................................ NIM



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Semester



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IPK



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Alamat



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Nama Orang Tua/Wali : ................................................................................................ Perkerjaan



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Penghasilan



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Alamat



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Bermaksud untuk mengajukan beasiswa : ..................................................................... Demikian surat permohonan ini dibuat. Atas perhatian Bapak/Ibu saya ucapkan terima kasih. Wassalamu’alaikum Wr.Wb Bandung, .......,...................,............ Pemohon



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BIODATA CALON PENERIMA BEASISWA DATA MAHASISWA Nama



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NIM



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Semester



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Tempat,Tanggal Lahir



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Jenis Kelamin



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Agama



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Alamat



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PRESTASI AKADEMIK 1. IPK



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2. Organisasi



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Prestasi



: a. ........................................................................................... b. ........................................................................................... c. ...........................................................................................



DATA ORANGTUA/WALI Nama Orangtua/Wali



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Perkerjaan



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Penghasilan



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Alamat



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Bandung,.........,....................2019 Orangtua/ Wali



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Calon Penerima Beasiswa



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