Application Form UMAC

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OPEN RECRUITMENT

UNISSULA MEDICAL ACADEMIC CLUB (UMAC)FAKULTAS KEDOKTERAN UNNIVERSITAS ISLAM SULTAN AGUNG SEMARANG

Name: Nick Name:Student ID Number:Batch: Sex:Place, Date of Birth: Address:Current Address:Hobbies:Phone Numbers :Describe UMAC in 5 words!

What do you know about UMAC ?

What do you want from UMAC ?

Photo3 x 4print/tempelSemarang, April th, 2013

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Notes : 1. Submit your applycation form by email to [email protected] before April 26th, 2013 on 11.59 p. m. Naming your apllycation form by: name_student ID number_UMAC2. Or you can also print out the applycation form and please kindly to contact our representative persons 3. Your photo must be submitted too4. CP : ALVENIA 085 7274 22268 KARINA 085 640 371 800

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