UT School

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Your Name

Birthplace

Date of Birth

Male Female

Address

Phone

Id Card Number

Hobby

SMK SLTA

School Name

Department

Other Department

The average value of report cards (2 last semester)

The average value of mathematics (2 last semester)

Number of siblings

What order do you come in your family

Your youngest sibling age

How is your learning patterns? explain!

Would you like on the job training beyond the current location? (Java, Banjarmasin, Adaro, Makassar, Medan, Pekanbaru, Semarang)

Yes No

Are you willing to obey school rules?

Yes No

School programs that interest you

Mechanic Operator IT-Programmer

Select Campus

Select Test Location

Describe your motivation to attend school programs mechanic / operator / IT-Programmer

Have you ever had a serious illness and should be treated?

Yes No

Body Height (cm)

Body Weight (kg)

Do you wear glasses?

Yes No

Are you color blind?

Yes No

Address & contact no. phone can be contacted if there is something important

Would you like to move the program / directed by the school (according to the results of the evaluation of the school)

Yes No

Additional Information

Photo (Max 1Mb)

Diploma (Max 1Mb)

Identity card (Max 1Mb)

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LATER WHEN FOUND IMPROPER INFORMATION
I AM WILLING TO BE RESPONSIBLE IN FRONT OF LAW.

Terms & Condition

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