SILIWANGI UNIVERSITY TASIKMALAYAFACULTY OF EDUCATIONAL SCIENCES AND TEACHERS’ TRAINING

ENGLISH DEPARTMENT STUDENTS’ ASSOCIATION (EDSA)Jalan Siliwangi 24, Telp. (0265) 330634 Tasikmalaya 46115

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Formulir Pendaftaran

English Singing Contest

Nama : …………………………………………………….

Alamat : …………………………………………………….

Tempat, Tanggal Lahir : …………………………………………………….

Sekolah/Perguruan Tinggi : …………………………………………………….

Pilihan Lagu :……………………………………………………..

No. Telepon : …………………………………………………….

Media Sosial : Intagram …………………..

Twitter …………………….

Facebook …………………..

________________, _____ November 2015

Peserta,

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Pas Foto

3 X 4 cm