Filling Out Form Mengisi Formulir
Application Form Formulir Aplikasi Registration Form Formulir Pendaftaran
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Form is a printed or typed document with blank spaces for insertion of required or requested information Formulir adalah dokumen yang dicetak atau diketik dengan ruang kosong untuk memasukkan informasi yang diperlukan atau diminta
Pengisian formulir sering ditemukan ketika kita akan mengisikan dan mendaftarkan diri kita di suatu sekolah, perusahaan, organisasi, rumah sakit, seminar, bank untuk membuat rekening ,kantor imigrasi untuk membuat passport, membuat KTP, berbelanja online dll
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Formulir itu biasanya berkaitan informasi diri kita terkait dengan hal dibawah ini
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Name |
Nama |
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Full name |
Nama lengkap |
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First name |
Nama depan |
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Last name |
Nama belakang |
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Nick name |
Nama panggilan |
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Gender |
Jenis Kelamin |
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Sex |
Jenis Kelamin |
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Marital status |
Status perkawinan |
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Nationality |
Kewarganegaraan |
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Birth date |
Tanggal lahir |
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Birth year |
Tahun lahir |
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Place of birth |
Tempat lahir |
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Age |
Usia |
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Hometown |
Kota asal |
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City |
Kota |
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State/Region |
Provinsi atau daerah |
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Province |
Provinsi |
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Zip/Postal code |
Kode pos |
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Country |
Negara |
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Neighborhood |
Kelurahan atau komplek |
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Address |
Alamat |
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Phone |
Telepon |
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Mobile |
Nomor ponsel |
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Fax |
Nomor faksimile |
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Alamat email |
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School |
Nama sekolah |
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College |
Nama perguruan tinggi |
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Nationality |
Kebangsaan |
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Family Member |
Anggota keluarga |
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Employment Status |
Status Pekerjaan |
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Social Function of Form Fungsi Sosial Formulir
Untuk melamar sesuatu
Untuk mendapatkan beberapa informasi
Untuk merekam pertanyaan pelanggan
Untuk memberikan beberapa informasi tentang pelamar
Untuk melakukan pemesanan atau reservasi
Untuk mengumpulkan informasi yang relevan dan diperlukan dari pemohon
Untuk meminta pendapat orang
Digunakan untuk mungumpukan informasi yang relevan dan diperlukan dari pemohon |
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Generic structure of Form |
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Generic Structure of Form Struktur Umum Formulir
Kepala Name of organization and/or department along with address and telephone number Nama organisasi dan atau departemen disertai alamat dan nomor telepon
Instruksi tentang cara mengisi formulir
Isi The section filled in such as name, date of birth ,address, phone number, etc Bagian yang diisi seperti nama, tanggal lahir, alamat, nomor telepon, dll
Pentutup The closing can contain terms and conditions or an agreement that ends by filling in the name of the place and the date the form is signed Penutup bisa berisi syarat dan ketentuan atau persetujuan yang diakhiri pengisian nama tempat dan tanggal formulir ditanda tangani
Tanda tangan
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PART A JOB APPLICATION FORM FORMULIR LAMARAN PEKERJAAN
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1 |
Apply for position: |
Posisi yang dilamar: |
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2 |
Full name: |
Nama lengkap: |
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3 |
Place , date and birth |
Tempat, tanggal dan lahir |
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4 |
Current Address |
Alamat saat ini |
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5 |
Home Address (as ID) |
Alamat Rumah (sebagai ID) |
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6 |
Parents home address |
Alamat rumah orang tua |
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7 |
Tax File Number |
Nomor File Pajak (NPWP) |
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8 |
Bank Account Number |
Nomor rekening bank |
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9 |
Bank Name |
Nama Bank |
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10 |
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Surat elektronik |
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11 |
Home Phone Number |
Nomor Telepon Rumah
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12 |
Office Phone number |
Nomor telepon kantor |
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13 |
Hand phone number |
Nomor telepon genggam |
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14 |
Parents Phone number |
Nomor telepon orang tua |
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15 |
Religion |
Agama |
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16 |
Sex ( Male/female) |
Jenis Kelamin (Pria/Wanita) |
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17 |
Marital satatus |
Status pernikahan |
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18 |
ID Card Number |
Nomor kartu identitas |
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19 |
Hobby |
Hobi |
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20 |
Father name |
Nama ayah |
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21 |
Mother name |
Nama ibu |
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22 |
Brother and sister: |
Saudara laki-laki dan saudara perempuan |
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23 |
Education |
Pendidikan |
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24 |
Working experience |
Pengalaman kerja |
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25 |
Employee |
Perusahaan |
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26 |
Position |
Jabatan |
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PART B Bank Deposit Slip Slip Setoran Bank
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1 |
Saving : |
Tabungan |
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2 |
Deposit to : |
Disetor ke: |
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3 |
Account Number : |
Nomor rekening : |
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4 |
Name : |
Nama: |
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5 |
Currency : Rupiah / Forex |
Mata uang : Rupiah / Valuta asing (Valas) |
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6 |
Depositor : |
Penyetor : |
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7 |
Name : |
Nama: |
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8 |
Address : |
Alamat: |
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9 |
Source of Fund : |
Sumber Dana: |
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10 |
Remark: |
Keterangan: |
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11 |
Loan: |
Pinjaman |
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12 |
Cash/ Cheque |
Tunai/ Cek/Girobiyet |
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13 |
Amount : |
Jumlah |
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14 |
Cash: |
Tunai: |
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15 |
Subtotal: |
Subtotal: |
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16 |
Rate : |
Kurs: |
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17 |
Charges: |
Biaya: |
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18 |
Total: |
Total: |
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19 |
Amount in words : |
Terbilang: |
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20 |
Teller: |
Kasir: |
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21 |
Depositor Signature |
Tanda Tangan Penyetor |
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Part B Job Application Form Formulir Lamaran Pekerjaan
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1 |
Name: |
Nama |
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2 |
Date of Birth: |
Tanggal Lahir |
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3 |
Postal Address: |
Alamat Pos |
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4 |
Permanent Address: |
Alamat tetap |
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5 |
Phone: |
Telepon |
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6 |
Mobile Phone: |
Telepon genggam |
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7 |
Email Address: |
Alamat surat elektronik |
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8 |
Marital status: |
Status pernikahan |
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9 |
Qualifications: |
Kualifikasi |
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10 |
Present Employer : |
Majikan sekarang |
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11 |
Current Position: |
Posisi saat ini |
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12 |
Experience in position being aplied for : |
Pengalaman di posisi yang dilamar : |
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13 |
Total Exprinence : |
Pengalaman total: |
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14 |
Present Salary: |
Gaji saat ini: |
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15 |
Expected Salary : |
Gaji yang diharapkan : |
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16 |
Willing to serve in Jakarta : ( Yes/No) |
Bersedia untuk melayani di Jakarta ( Ya/Tidak) |
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17 |
Which other position you inted to apply ? |
Posisi mana lagi yang ingin Anda lamar? |
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PART C Bus Ticket Purchase Form Formulir Pembelian Tiket Bus
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1 |
Destination: |
Tujuan: |
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2 |
Date: |
Tanggal: |
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3 |
Departure Time : |
Waktu Keberangkatan: |
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4 |
Number of Passanger: |
Jumlah Penumpang: |
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5 |
Number of Adult: |
Jumlah Dewasa: |
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6 |
Number of Children: |
Jumlah anak: |
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7 |
No Gate: |
No Gerbang : |
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8 |
Customer and booking detail |
Detail pelanggan dan pemesanan |
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9 |
Customer Name : |
Nama Pelanggan: |
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10 |
Phone: |
Telepon: |
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11 |
Booking Total : |
Jumlah pemesanan : |
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12 |
Payment : |
Pembayaran: |
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PART D Resturant Booking Form Formulir Pemesanan Restoran |
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1 |
Contact Name : |
Nama Kontak |
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2 |
Contact Number: |
Nomor Kontak |
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3 |
Number of People : |
Jumlah Orang |
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4 |
Booking Date: |
Tanggal Pemesanan |
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5 |
Booking Time: |
Waktu Pemesanan |
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6 |
Comment : Would love a seat by the window if possisible |
Komentar : Ingin duduk di dekat jendela jika memungkinkan? |
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PART E Student information form Formulir informasi siswa
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1 |
Student’s Full Name: |
Nama lengkap siswa: |
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2 |
Student’s Address: |
Alamat siswa: |
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3 |
Home phone: |
Telepon rumah: |
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4 |
Date of Birth: |
Tanggal lahir: |
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5 |
Place of Birth: |
Tempat Lahir: |
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6 |
Color of Eyes: |
Warna mata: |
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7 |
Color of Hair: |
Warna rambut: |
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8 |
Height: |
Tinggi: |
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9 |
Mother’s name / Work phone |
Nama ibu / Telepon kantor
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11 |
Father’s name/ Work phone |
Nama Ayah/ Telepon Kantor |
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PART F HOTEL ROOM RESERVATION RESERVASI KAMAR HOTEL
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1 |
Name: |
Nama: |
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2 |
Address: |
Alamat: |
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3 |
Firm: |
Perusahaan: |
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4 |
Single Bed: |
Tempat tidur tunggal: |
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5 |
Double Bed: |
Tempat tidur ganda: |
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6 |
Date of Arrival : |
Tanggal kedatangan : |
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7 |
Time of Arrival : |
Waktu kedatangan: |
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8 |
Day of week : |
Hari dalam seminggu : |
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9 |
Departure date : |
Tanggal keberangkatan: |
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10 |
Rate $ : |
Nilai $: |
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11 |
Deposit $: |
Setor $: |
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12 |
Made by : |
Dibuat oleh : |
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13 |
Date : |
Tanggal : |
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14 |
Address |
Alamat |
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15 |
Received by : Phone/ Letter/ Wire/ Verbal |
Diterima melalui : Telepon/ Surat/ Kawat/ Lesan |
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16 |
Taken by : |
Diambil oleh : |
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17 |
Confirmed by : |
Dikonfirmasi oleh : |
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18 |
Date: |
Tanggal: |
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PART G TOUR RESERVATION FORM Formulir reservasi wisata
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1 |
Tour name : |
Nama tur : |
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2 |
Tour date: |
Tanggal tur: |
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3 |
First name |
Nama depan |
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4 |
Middle name |
Nama tengah |
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5 |
Last name |
nama keluarga |
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7 |
Address |
Alamat |
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8 |
City |
Kota |
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9 |
State |
Negara |
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10 |
Telephone home |
Telepon rumah: |
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11 |
Cell phone |
Telepon selular: |
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12 |
Date of Birth |
Tanggal lahir: |
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13 |
Rooming with |
Sekamar dengan: |
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14 |
Email Address |
Alamat email: |
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15 |
Emergency Contact Information Name : |
Informasi Kontak Darurat Nama: |
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16 |
Relationship: |
Hubungan: |
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17 |
Telephone: |
Telepon: |
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18 |
Tour price : |
Harga tur: |
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19 |
Deposit Amount |
Jumlah Deposit |
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20 |
Insurance (Yes.No) Paid with deposit |
Asuransi (Ya.Tidak) Dibayar dengan deposit
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21 |
Final payment amount |
Jumlah pembayaran akhir |
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22 |
Deposit Due Date |
Tanggal Jatuh Tempo Setoran |
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23 |
Final Payment Due Date |
Tanggal Jatuh Tempo Pembayaran Akhir |
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24 |
Payment information : Circle one Deposit / Final payment |
Informasi pembayaran : Lingkari satu Setoran / Pembayaran terakhir
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25 |
Amount of payment: |
Jumlah pembayaran: |
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26 |
Check number : |
Nomor cek: |
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27 |
Cash: |
Tunai: |
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28 |
Make checks payable to : |
Melakukan pembayaran cek ke: |
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29 |
Credit card number : |
Nomor kartu kredit: |
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30 |
Expiration date : |
Tanggal habis tempo: |
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31 |
Security code ( 3 digit on back) |
Kode keamanan (3 digit di belakang) |
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32 |
Name as it appears on credit card |
Nama seperti yang tertera di kartu kredit |
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33 |
Billing adress ( if different from adress above) |
Alamat penagihan (jika berbeda dengan alamat di atas) |
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34 |
Special request or dietary requirements |
Permintaan khusus atau persyaratan diet |
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35 |
Annivesary or special occasion |
Ulang tahun atau acara khusus |
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36 |
Medical or mobility issues |
Masalah medis atau mobilitas |
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PART H Cake Order Form Formulir Pemesanan Kue
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1 |
Name : |
Nama: |
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2 |
Phone Number : |
Nomor telepon : |
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3 |
E-Mail : |
Suatr elektronik: |
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4 |
Cake Size ( 6 inch, Half sheet/Full sheet/ 6-8 servings, $ 9.99) |
Ukuran Kue (6 inci, Setengah lembar/Lembar penuh/6-8 porsi, $9.99) |
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5 |
Cake Flavor (Vegan chocolate) |
Rasa Kue (cokelat Vegan)
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6 |
Cake Filling ( Strawberry butter cream ) |
Isi kue (butter cream stroberi)
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7 |
Cake Icing ( Cream cheese) |
Lapisan gula kue (krim keju) |
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PART I Cash Withdrawl Slip in the bank Slip Penarikan Tunai di bank
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1 |
Branch of the bank: |
Cabang banknya: |
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2 |
Date: |
Tanggal: |
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3 |
Currency: |
Mata uang: |
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4 |
Account Name: |
Nama akun: |
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5 |
Account No : |
No rekening : |
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6 |
Amount : |
Jumlah : |
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7 |
Amount in words : |
Jumlah dalam kata-kata: |
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8 |
Transaction : |
Transaksi : |
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9 |
Authorized signature : |
Tanda tangan resmi : |
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PART J Birthday Party Reservation Form Formulir Pemesanan Pesta Ulang Tahun
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1 |
Parent’s name: |
Nama orang tua: |
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2 |
Party day: |
Hari pesta: |
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3 |
Child’s name: |
Nama anak: |
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4 |
Child’s age: |
Usia anak: |
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5 |
Party date: |
Waktunya berpesta: |
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6 |
Party time: |
Waktunya berpesta: |
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7 |
Adresss: |
Alamat: |
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8 |
Phone: |
Telepon: |
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9 |
Type of party: |
Jenis pesta: |
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10 |
Theme of party: |
Tema pesta: |
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11 |
Member / Non member : |
Anggota / Non anggota :
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12 |
Current cost of party: |
Biaya pesta saat ini: |
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13 |
Theme choice ( Tea party/pirate island) |
Pilihan tema (Pesta teh/pulau bajak laut) |
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14 |
Payment information |
Informasi Pembayaran : |
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15 |
Deposit : |
Menyetorkan : |
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16 |
Amount required: |
Jumlah yang dibutuhkan: |
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17 |
Amount paid: |
Jumlah yang dibayarkan |
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18 |
Date paid: |
Tanggal dibayar:
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19 |
Method of payment ( cash/check/credit ) |
Cara Pembayaran (Cash/Cek/Kredit) |
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20 |
Balance : |
Keseimbangan/ Nereca: |
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21 |
Due: |
Jatuh tempo: |
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22 |
Date required : |
Tanggal dibutuhkan : |
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23 |
Date paid: |
Tanggal dibayar: |
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24 |
Method of payment (Cash/check/credit) |
Cara pembayaran (Cash/cek/kredit) |
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25 |
Rental party agreement mail date : |
Tanggal surat perjanjian sewa pesta : |
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26 |
Notes : |
Catatan: |
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PART K Medical Consent Form Formulir Persetujuan Medis
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1 |
First Name : |
Nama depan : |
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2 |
Middle Name : |
Nama tengah : |
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3 |
Last Name : |
Nama keluarga : |
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4 |
Birth of Date : |
Tanggal lahir : |
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5 |
Gender ( Male/Female/Other) |
Jenis Kelamin (Pria/Wanita/Lainnya) |
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6 |
Address: |
Alamat: |
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7 |
Cell Phone : |
Telepon selular: |
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8 |
Home Phone : |
Telepon Rumah: |
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9 |
Email: |
Surat Elektronik: |
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10 |
Emergency Contact Information |
Informasi Kontak Darurat |
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11 |
Name : |
Nama: |
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12 |
Relationship to the patient : |
Hubungan dengan pasien : |
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13 |
Address : |
Alamat : |
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14 |
Cell Phone: |
Telepon selular: |
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15 |
Home Phone: |
Telepon rumah: |
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16 |
Work Phone : |
Telepon Kantor : |
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17 |
Email : |
Surel : |
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18 |
Signature : |
Tanda tangan : |
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19 |
Date : |
Tanggal : |
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PART L Purchase Order Pesanan Pembelian
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1 |
Date : |
Tanggal : |
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2 |
No of Purchase Order : |
Jumlah Pesanan Pembelian : |
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3 |
Vendor Name: |
Nama pedagang: |
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4 |
Company Name : |
Nama perusahaan : |
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5 |
Address (City/State/Zip code) |
Alamat (Kota/Negara Bagian/Kode Pos) |
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6 |
Phone : |
Telepon: |
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7 |
Ship to : |
Dikirim ke : |
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8 |
Company Name : |
Nama Perusahaan : |
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9 |
Address (City/State/Zip code) |
Alamat (Kota/Negara Bagian/Kode Pos) |
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10 |
Phone : |
Telepon: |
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11 |
Detail of Items /Goods |
Detail Barang/Barang |
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12 |
Quantity: |
Kuantitas: |
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13 |
Unit price: |
Harga satuan: |
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14 |
Sub Total: |
Subtotal: |
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15 |
Tax : |
Pajak : |
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16 |
Total : |
Jumlah: |
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17 |
Additional Notes : |
Catatan Tambahan: |
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18 |
Signature of Authorize Person: |
Tanda tangan orang yang berwenang: |
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19 |
Write Designation Here : |
Tulis sebutan disini: |
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PART M Money Order Deposit Slip Slip Setoran Wesel
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1 |
Mail to : |
Kirim ke: |
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2 |
Money order amount ( $) : |
Jumlah wesel ($): |
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3 |
Inmate’s ID Number: |
Nomor ID Narapidana
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4 |
Inmate’s full name ( Last/First): |
Nama lengkap narapidana (belakang/depan) |
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5 |
Institution: |
Lembaga |
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6 |
Your email: |
Email mu |
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7 |
Your First Name: |
Nama pertama Anda |
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8 |
Your Last Name: |
Nama belakangmu |
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9 |
Your City: |
Kotamu |
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10 |
Your State : |
Negara Anda |
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11 |
Your Zip |
Kode pos |
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PART N Individual Account Opening Application Form Formulir Apilkasi pembukaan Rekening Individual |
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1 |
Applicant Data Data Pemohon |
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2 |
First Name : |
Nama depan |
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3 |
Last Name: |
Nama belakang |
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4 |
Alias name: |
Nama alias |
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5 |
Sex( Male/Female ) |
Jenis kelamin(Laki-laki/perempuan) |
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6 |
Marital status ( Maried / single/window/widower |
Status pernikahan ( menikah/lajang/Janda/Duda |
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7 |
Place/ Date of birth : |
Tempat / Tanggal Lahir : |
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8 |
Mother’s Maiden name |
Nama gadis ibu kandung |
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9 |
Identitity : ID card/ Temporary residence/ passport |
Tanda pengenal: KTP/ KITAS/KITAP/ Paspor |
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10 |
ID Number : |
No Identitas |
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11 |
Expiry date: Valid for life |
Berlaku sd Berlaku seumur hidup
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12 |
Place of issuance |
Tempat diterbitkan |
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13 |
Date of issuance |
Tanggal diterbitkan |
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14 |
Nationality (WNI/WNA Native country |
Kewarganegraan (WNI/WNA/Negara asal |
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15 |
Religion: Moslem/ Christian/ Catholic/ Buddist/ Hindu/ Kong Hu Cu |
Agama : Islam/ Kristen/ Katholik/ Buddha/ Hindu/ Kong Hu Cu |
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16 |
Tax ID Number : Possess/Not possess |
NPWP: Ada/tidak ada |
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17 |
Place of Issuance : |
Tempat diterbitkan |
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18 |
Date of Issuance: |
Tanggal diterbitkan |
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19 |
Adress as stateted in Id card (Copy attached) |
Alamat sesuai tanda pengenal Fotokopi terlampir |
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20 |
Present Residence Address |
Alamat tempat tingga terkini |
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21 |
Village |
Desa/Kelurahan |
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22 |
Sub District |
Kecamatan |
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22 |
City |
Kota |
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23 |
Province |
Propinsi |
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24 |
Country |
Negara |
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25 |
Zip code |
Kode pos |
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26 |
Ownership of residence : Ownhouse/ famiy owned house/ offical residence/ Own house used as collateral/ Rented house |
Satatus Tempat Tinggal : Milik sendiri/ milik keluarga/ rumah dinas/ Milik sendiri dijaminkan/ sewa/kontak |
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27 |
Phone Number |
No Telepon |
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28 |
Fax Number |
No Fax |
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29 |
Cell phone |
No. HP |
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30 |
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31 |
Educational Background Latar belakang pendidikan |
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32 |
Elementary |
SD |
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33 |
Junior high |
SMP |
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34 |
Senior high school |
SMA/Sederajat |
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35 |
Diploma |
D1-D2 |
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36 |
Academy |
D3 |
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37 |
Degree |
S1 |
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38 |
Master |
S2 |
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39 |
Doctoral |
S3 |
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40 |
Others, please specify |
Lain lain, jelaskan.. |
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41 |
Occupational Background : Student/ Private employee/ Retired House wife Civil employee Teacher
Self employed Army Police Others |
Latar Blk Pekerjaan: Pelajar/Mahasiswa Pegawai Swasta Pensiunan Ibu Rumah Tangga Pegawai Negeri Guru Wiraswasta TNI AD Polisi Lainnya |
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42 |
Signature |
Tanda tangan |
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43 |
Name of Working Place : |
Nama tempat kerja |
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44 |
Adress of Working Place : |
Alamat tempat kerja |
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45 |
Line of Businness: |
Bidang Usaha : |
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46 |
Job Position: |
Jabatan Pekerjaan : |
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47 |
Length of employment(Years/Months) |
Lama bekerja Tahun/bulan |
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48 |
Monthly Income |
Jumlah pengilan per bulan |
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49 |
Income Frequency (daily/weekly) |
Frekuensi penghasilan (daily/weekly) |
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50 |
Annual Income |
Jumlah penghasilan per tahun |
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51 |
Spouse data |
Data suami atau istri |
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52 |
Name spouse |
Nama suami atau istri |
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53 |
Residence Address |
Alamat tempat tinggal |
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54 |
Spouse Occupation :
Employees/ Self employee/ Professional/ Others |
Data Pekerjaan suami atau istri:
Karyawan Wiraswasta Profesional Lain-lain |
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55 |
Company working place |
Nama perusahaan tempat kerja |
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56 |
Line of business |
Bidang usaha |
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57 |
Company/Instution address |
Alamat perusahaan |
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PART O Medical Form Formulir Medis
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1 |
Name : |
Nama: |
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2 |
Age: |
Usia: |
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3 |
Address : |
Alamat : |
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4 |
Phone: |
Telepon: |
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5 |
D.O.B : |
D.O.B : |
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6 |
Phone: |
Telepon: |
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7 |
Blood Type (if known) |
Golongan Darah (jika diketahui) |
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8 |
Sex: |
Jenis Kelamin |
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9 |
Doctor’s name :/Phone : |
Nama Dokter :/Telepon : |
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10 |
Next of Kin / Phone/ Relation/ |
Berikutnya dari dari kerabat Telepon/ Hubungan |
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11 |
Insurance Company: / Insurance No: |
Perusahaan Asuransi: / No Asuransi |
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12 |
Allergies : List all : Medicine, Food , Pants, Animals, etc |
Alergi : Daftar semua: Obat-obatan, Makanan , Tanaman, Hewan, |
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13 |
Healt problems : List all : Heart, Respiratory, Blood pressure, Asthma , Diabetes, etc |
Masalah Kesehatan : Daftar semua: Jantung, pernapasan, Tekanan darah, asma, Diabetes, dll |
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14 |
Medicine taken taken ( Please list name, Dosage and how often) |
Obat yang diminum (sebutkan nama, dosis dan seberapa sering)
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15 |
Place where do you keep your medicine while in the house ? |
Di mana Anda menyimpan obat selama di rumah? |
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16 |
Do you live a living will or advance medical directive ? if so where ? |
Apakah Anda menjalani hidup akan atau memajukan arahan medis? jika demikian dimana?
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17 |
Name , Signature, Parent or guardian , date |
Nama, Tanda Tangan, Orang Tua atau Wali, Tanggal |
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Instructions for filling out the form Instruksi dalam pengisian formulir
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1 |
Please complete this form with black inkand write within the boxes with CAPITAL Letters |
Isilah formulir ini dengan tinta hitam dan tulis di dalam kotak dengan huruf KAPITAL
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2 |
Please provide correct information |
Tolong berikan informasi yang benar |
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3 |
Do not leave spacs blank |
Jangan tinggalkan ruang kosong |
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4 |
Please tick the boxes with yes or no |
Silakan centang kotak dengan ya atau tidak |
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5 |
Please tick one |
Silakan centang satu |
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6 |
Please check before submitting |
Harap periksa sebelum mengirimkan |
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7 |
Submit to the office before july 30 2021 |
Kirim ke kantor sebelum 30 Juli 2021 ke layanan kesehatan |
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8 |
This form should be carried on your person and on file with your commander |
Formulir ini harus dibawa sendiri dan disimpan oleh komandan Anda
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9 |
To avoid jeopardizing enollment, complete this medical consent form and return it to health services promptly |
Untuk menghindari bahaya pendaftaran, lengkapi formulir persetujuan medis ini dan segera kembalikan |
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10 |
Form should be updated as needed |
Formulir harus diperbarui sesuai kebutuhan
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11 |
Circle one |
Lingkari satu
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12 |
Please complete one form for each individual traveler |
Harap lengkapi satu formulir untuk setiap wisatawan individu |
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13 |
Office use only |
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14 |
A 24-hour information hotline is available for tourist at + 09887878979 |
Hotline informasi 24 jam tersedia untuk turis di + 09887878979
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15 |
Ways to submit the medical consent form, Scan and upload to the health office at www.XXXX.com |
Cara penyerahan formulir persetujuan medis, Scan dan upload ke dinas kesehatan di www.XXXX.com |
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16 |
Tick or cross on dotted line or in a box |
Centang atau silang pada garis putus-putus atau di dalam kotak
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17 |
Delete the option that does not apply |
Hapus opsi yang tidak berlaku
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18 |
Write “Yes” or “ No” as appropriate |
Tulis “Ya” atau “Tidak” sebagaimana mestinya |
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19 |
This form is required for students under the age of 18. It must be completed in full by student’s parent or guardian |
Formulir ini wajib diisi oleh siswa di bawah usia 18 tahun. Formulir ini harus diisi secara lengkap oleh orang tua atau wali siswa |
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Alamat kami :
Gadjah Mada English School ( GMES) Jl. Kadipaten Kulon No. 27 B , Kraton Yogyakarta
Phone / HP/ WA : 0812 274 7050
Website : gmesenglish.blogspot.com Instagram : gmesenglish
Bantuan Transportasi :
Google Map : tulis “ gmes english “ Gojek : tulis “ gmes english ” Grab : tulis ” gmes english ”
----- Belajar Bahasa Inggris bisa dengan internet /online dengan Aplikasi “ Zoom Meeting “ dan “ Google Meet”
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