FORMULIR PENDAFTARAN UMROH
FORMULIR PENDAFTARAN UMROH
1. No. KTP :
...............................................................................................................
2. Nama
Lengkap :
...............................................................................................................
3. Nama
Ayah Kandung :
...............................................................................................................
4. Tempat
& Tgl Lahir : ...............................................................................................................
5. Jenis
Kelamin :
...............................................................................................................
6. Alamat
Lengkap :
...............................................................................................................
...............................................................................................................
...............................................................................................................
No. Telp/HP :
...............................................................................................................
Email :
...............................................................................................................
7. Riwayat
Penyakit :
...............................................................................................................
8. Pilihan
Kamar : a. Quad b. Triple c. Double
9. Pekerjaan :
...............................................................................................................
10. Pilihan Paket Umroh :
...............................................................................................................
11. Deposit
Rupiah/USD :
12. Keluarga
yang dapat di hubungi :
Nama :
...............................................................................................................
No. HP :
...............................................................................................................
13. Info / Rekomendasi dari : ...............................................................................................................
14. Saya
besedia mentaati segala ketentuan dan jadwal yang telah ditetapkan dan
menyetujui tetap bersama rombongan sesuai peraturan yang telah berlaku dari
berangkat hingga kembali
........................TGL...................20....
(..........................................)
Calon Jamaah
0 Response to "FORMULIR PENDAFTARAN UMROH"
Post a Comment