FORMULIR PENDAFTARAN AKSINEAS ACTING & FILM SCHOOL
Nama Lengkap : .............................................................................................. Tempat/Tgl.Lahir : .............................................................................................. Pendidikan Terakhir : .............................................................................................. Nama Orangtua : .............................................................................................. Tinggi/Berat Badan :...........Cm/............Kg UkuranBaju/Sepatu :............. / .............. Pilihan Diklat : a. Akting b. Penulisan Skenario Film Alamat rumah : .............................................................................................. .............................................................................................. Telp. …...........……………………. Hp. …......…...............………………………… Email/FaceBook : .............................................................................................. Pengalaman Akting/Seni : .............................................................................................. Jakarta, ......................2016
_________________________ Tanda tangan & nama lengkap |