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Form Pendaftaran Konsultasi HELPDESK Pencalonan Legislatif
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Tanggal Konsultasi
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MM
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DD
/
YYYY
Jam Konsultasi
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Time
:
AM
PM
Nama
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Your answer
Jabatan
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Your answer
Jenis Kelamin
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Laki-Laki
Perempuan
Other:
Nomor Handphone
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Your answer
Instansi/Lembaga
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Partai Kebangkitan Bangsa
Partai Gerakan Indonesia Raya
Partai Demokrasi Indonesia Perjuangan
Partai GOLKAR
Partai Nasdem
Partai Buruh
Partai Gelombang Rakyat Indonesia
PARTAI KEADILAN SEJAHTERA
Partai Kebangkitan Nusantara
Partai Hati Nurani Rakyat
Partai Garda Perubahan Indonesia
Partai Amanat Nasional
Partai Bulan Bintang
Partai Demokrat
Partai Solidaritas Indonesia
PERINDO
Partai Persatuan Pembangunan
Partai Ummat
Other:
Kebutuhan Konsultasi
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Your answer
Media/Bentuk Konsultasi
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Tatap Muka
Telephone
Video Congerence/Zoom
Chat
Other:
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