PANITIA MABIT RAMADHAN
PONDOK PESANTREN MUHAMMADIYAH TAHFIDZUL QURAN (PPMTQ)
AL-IJTIHAD SIRAU
Sekretariat
: Jalan Balai Desa RT. 02 RW. 07 Sirau
Kemranjen Banyumas. 53194. Telp. 081903197019
FORMULIR PENDAFTARAN
MABIT
RAMADHAN
PONDOK PESANTREN MUHAMMADIYAH TAHFIDZUL QURAN
(PPMTQ)
AL-IJTIHAD
SIRAU KEMRANJEN BANYUMAS
NAMA :....................................................................................
TEMPAT TANGGAL LAHIR :....................................................................................
JENIS KELAMIN :....................................................................................
ASAL SEKOLAH/KELAS :....................................................................................
ALAMAT :Desa................................RT..........RW......................
ORANG TUA :……………………………………………………...
AYAH :....................................................................................
IBU :....................................................................................
NO HP :………………………………………………………
ALASAN MENGIKUTI KEGIATAN MABIT
RAMDHAN :…………………………………………………………………………………………………………………………………………………………………………………………………………………………
………………….., ……………………………
Wali Siswa
(………………………………..)
·
Nb:
-
Pendaftaran
Rp.100.000
Kirim Formulir KLIK
