Formulir Pendaftaran Mahasiswa Baru

New Student Admission Form

Lengkapi data di bawah ini sesuai dengan dokumen asli (KTP/KK/Ijazah)

"Please ensure all information matches your legal identification documents (National ID/Family Registry/Academic Transcript).
DATA PRIBADI (Personal Identity)
Full Name (According to Certificate)
National ID Number
Religion
Nationality
Gender
Marital Status
Place of Birth
Date of Birth
KONTAK & ALAMAT (Contact Details)
Current Residential Address
Province
City / Regency
District
Postal Code
WhatsApp Number
Active Email Address
PENDIDIKAN ASAL (Education Background)
National Student ID
School Origin
High School Major
Institution Name
Graduation Year
DATA ORANG TUA / WALI (Parental Info)
Father's Full Name
Mother's Full Name
Occupation
Monthly Income
Parent's Phone Number
TAHFIZ & PILIHAN PROGRAM STUDI (Academic Choices)
Current Quran Memorization (Juz)
Juz
Tahfiz Program Selection
1st Choice Program
2nd Choice Program
Admission Path
UNGGAH BERKAS (Upload Documents)
Formal Photo (JPG, Merah/Biru)

*Maksimal Ukuran File 1MB

Certificate Scan (PDF Format)

*Maksimal Ukuran File 1MB

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