FORMULIR PENDAFTARAN PELATIHAN BAHASA JERMAN
Krapyak Wetan RT 05 No 132 A, Panggungharjo, Sewon, Bantul, Yogyakarta 55188WA: 082135345850 Telp. (0274) 4221754 BBM D575B3AE
Mail: [email protected], www.deutscheszentrum-yogyakarta.blogspot.com
Nama :............................................................................................................. ................................................
Tempat Tanggal Lahir :............................................................................................................. ................................................
Pekerjaan :............................................................................................................. ................................................
Alamat :............................................................................................................. ................................................
Tlp :.............................................Hp :........................................................ ................................................
e-mail :................................................................................................. ............................................................
Sekolah/Universitas/Instansi :............................................................................................................. ................................
Fakultas/Jurusan/bagian :.......................................................................................................... ...................................
Level : A1, A2, B1, B1+, B2
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Program pilihan : …………………………………………………………………………………………………….
Alasan mengikuti kursus bahasa Jerman :.......................................................................................... ...............................
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Info DZY dari : …………………………………………………………………………………………………………………………...
Penting :
1. Peserta yang telah mendaftar & telah melakukan pembayaran wajib mengikuti kelas yang telah ditentukan oleh DZY
2. Peserta yang melakukan pembatalan setelah membayar maka biaya tidak dapat ditarik kembali, kecuali ada perjanjian sebelumnya.
3. Pembayaran dilakukan maksimal 5 hari sebelum kelas dimulai.
Staff
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Yogyakarta, …………………………………Pendaftar
(……………………………)
