form pendaftaran k3 - magna safetindo(2) new
TRANSCRIPT
![Page 1: Form Pendaftaran k3 - Magna Safetindo(2) New](https://reader031.vdocuments.mx/reader031/viewer/2022021302/577c7b7d1a28abe05497dab0/html5/thumbnails/1.jpg)
NAMA PESERTA : MIFTAKHUL NURDIANT JenisKelamin : LAKI - LAKI
JabatanHP/Diret
P!"neEmail
Per#sa!aan [email protected]
NAMA PESERTA :JenisKelamin : L/P
JabatanHP/Diret
P!"neEmail
Per#sa!aan Priba$i
NAMA PESERTA :JenisKelamin : L/P
JabatanHP/Diret
P!"neEmail
Per#sa!aan Priba$i
FORMULIR
PENDAFTARANPU%LI& TRAININ'
PENDAFTARAN
NAMA /
ALAMAT : Jln. Danau Tambora VI. No.88, RT 07/6, Abadijaya, Sukmajaya, Koa
D!"ok, Ja#a bara
KODEPOS : 1!1"
: M#FTAKHUL NURD#ANTO
: PERUSAHAAN PR#$AD#
NO. TELEPON : %&'!%()!! E*T : FA* :
P#+ TRA#N#N,P#+ F#NAN+E
-UDUL TRA#N#N,
TAN,,AL
::
: AK( UMUM SMK( AUD#TOR K(
: 1 (1 O0o2e3 )%1'
KETENTUAN PEM%A(ARAN1. Un40in5o3ma6i7em2a8a3an2i6amelal4i email [email protected]/ el7 0e )*+-,+.+*/,0e1t2*)3 denganA6i9Ra9a84). $40i 3an65e3 di0i3im0anmelal4i 5a ;%)1< )%&11/email [email protected]= 6elam2an8a )9a3i0e3>a6e2el4m9a3i H(. $ia8a7em2aalan / cancellaion 5ee :-i0adila040an6eela97engi6ian5o3m4li37enda5a3an=
-AKARTA= ' OKTO$ER )%1'
; M#FTAKHUL NURD#ANTO <Nama lengkap pemesan& cap perusahaan
-A$ATAN :
+2 Isi searalen45a6$an7elas$en4anmen44#na5an!#r#8 a6ital9ti$a5$i6er5enan5anmen44#na5ant#listan4an*2 Pesertaatas s6"ns"r Per#sa!aan9 serti5ata5an$i5irim5ealamat Per#sa!aan2 Pesertaatasnama6riba$i9 serti5ata5an$i5irim5ealamatPeserta2 F"rm#lirini!ara6$i5embali5anmelal#i8a1 : )*+;*<.)=++.ata# email :in8">6!ita4"ras2"2i$,2 Nama 6eserta trainin4 m"!"n$it#lissearalen45a6$an7elas
EMA#L P#+ TRA#N#N, :
Head Oce :PT. P9iago3a6 ,lo2al D4aR40o ,olden $o4lea3d $lo0 B1 -l. Pa9laCanSe3i24 $SD +i8=Se37ong Tange3ang Selaan 1'())
P9one : %)1 '(11!)! / '= %)1
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Fa : %)1 )%&11
Email : [email protected]
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-A$ATAN :
F#NAN+E :
MA,NA SAFET#NDOMA,NA SAFET#NDOe a3e T9e Acc3edied T3aining P3oide36
O5 9e 5olloCing o3ganiaion6
![Page 2: Form Pendaftaran k3 - Magna Safetindo(2) New](https://reader031.vdocuments.mx/reader031/viewer/2022021302/577c7b7d1a28abe05497dab0/html5/thumbnails/2.jpg)