Registration Form for Profession

*If the choice of PERIOD is not available please call : (021)54220808 or email to [email protected]

*Period

*Program Study

*If the choice of EXAM SCHEDULE is not available please call : (021)54220808 or email to [email protected]

Exam Schedule

Occupation

If you an UMN alumnus, please input your NIM below

NIM

A. PERSONAL DETAIL

*Full Name (Nama sesuai KTP/KK)

*Place of Birth (Kota Lahir sesuai KTP/KK)

*Date of Birth (Tanggal Lahir sesuai KTP/KK)

*Gender

*Citizen Identification Card

Religion

*Citizaen Identification Number

*Marital Status

*Address

*City

Postal Code

Phone

Phone number with Whatsapp account. Any payment notification will be sent to this number. Number only for mobile phone number.

*Nomer Handphone

*Email

B. CORRESPONDENCE DETAIL

*Correspondence Address

*Correspondence City

C. EDUCATION BACKGROUND - UNIVERSITY

*University Province

*University City

*Unviversity Name

University Address

*Academic Program

*Enrollment Year (yyyy)

*Graduation Year (yyyy)

example:3.75

*Final GPA

D. EDUCATION BACKGROUND - HIGH SCHOOL

*Enroll Year (yyyy)

*Graduation Year (yyyy)

*School Major

*School Country

*School Province

*School City

*School Name

School Address

E. PARENT INFORMATION

FATHER INFORMATION

Name

Date of Birth

Phone

Handphone

Address

Card ID (KTP)

Education

Occupation

Income

MOTHER INFORMATION

*Name

*Date of Birth

Phone

*Handphone

*Email

*Address

*Card ID (KTP)

*Education

*Occupation

*Income

F. COMPANY DETAIL

Company Name

Job Title

Business Line

Department

Address

City

Postal Code

Phone

Work Experience Date (yyyy)

G. UPLOAD FILE

F. UPLOAD FILE

*Maximum size for each file is 9MB with format zip, pdf, jpg, png.
*files that are not ready yet, can be submitted via email to [email protected]. Please inform your name and registration number in email

Identity ID

Certificate

Transcript

TOEFL

THESIS TITLE

*Thesis Topic Planning

Click Image to Refresh

Captcha