Active Volunteer

volunteer active AMDAL-KPSN
Registration form for active volunteer

Complete name :……………………..
Nickname : ……………………
Gender :
Hobby :................................
Address :……………………………………… Zip code........................
House telephone: …………………………………… Telephone office ……………………
No HP :…………………………………… No. Fax ……………………………
E-Mail :……………………………
Date of delivering birth :……………………………………………………………………………
Status is occupation in this time
. ( ) Work remain to
. ( ) Student
. ( ) Work part-timely
. ( ) Student
. ( ) don’t work
. ( ) Retired
. ( ) Work [by] x self
. ( ) others (specific) ………………………
For Student
School /University:..............Majors: .................................
Work …………………………………… Address office ...........................

enthused activity:
. ( ) Campaign
. ( ) Research into
. ( ) Graving Dock Fund
. ( ) Logistics
. ( ) Administration
. ( ) Manage activity / event organizer
. ( ) Write / copy writing
. ( ) Design gravies /web
. ( ) Visual ofcommunications
. ( ) Adjacent of society
. ( ) Facilitator / instructor
. ( ) Policy analyst
. ( ) Education of public
. ( ) Other, write down ....................

Do you wish to joint forces with milis discussion for AMDAL-KSPN ?
. ( ) Yes E-mail: ............................. ( ) Don’t

AMDAL-KPSN will not divide or propagate information /your data to other organization.