Juknis Pilot Project

C. Formulir PendaftaranFORMULIR PENDAFTARAN1. Judul Proposal : ..........................................................2. Nama Lembaga : ..........................................................3. Alamat Lengkap : .........................................................4. No Telp/No Fax : ........................................................5. Penanggung Jawab : .........................................................6. Alamat Lengkap :.........................................................7. URL/http : .........................................................8. Jenis Keterampilan : .........................................................9. Nama Bank : .........................................................10. No. Rek. Lembaga : ..........................................................11. Atas Nama : ..........................................................12. NPWP Lembaga : ..........................................................Pengusul,Penerima,(.............................) (.............................)20