DAFTAR RIWAYAT HIDUP

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DAFTAR RIWAYAT HIDUP

DATA PRIBADI

Nama Lengkap : ..................................................
Tempat, Tanggal Lahir : ..................................................
Domisili : ..................................................
Jenis Kelamin : ..................................................
Agama : ..................................................
Status : .................................................. (belum menikah/menikah)
Tinggi / Berat Badan : ..................................................
Telepon : ..................................................
e-mail : ..................................................
                                                         
RIWAYAT PENDIDIKAN

(1999) Lulus SDN Jambewangi 04 – Genteng
(2001) Lulus SLTPN 2 Genteng – Genteng
(2004) Lulus SMAN 1 Genteng – Genteng

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