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APPLICATION
FORM
3x4
photograph
st
Astra 1
Program
PERSONAL IDENTITY
Full Name: ELVIN PUTRI MARTHA ZENDRATO
Place & Date of Birth: Gunungsitoli 22 Desember 1990
Address: Jln. Jamin Ginting, kec. Medan Tuntungan
Email: julvinharzen@yahoo.co.id
Phone Number: Mobile: 085361889543
EDUCATION BACKGROUND
High School :Sekolah Tinggi Ilmu Kesehatan Sumatera Utara
University: STIKES SUMUT MEDAN
GPA: Semester I (3,19), Semester II (3,
10)
Faculty: S-1 KEPERAWATAN
Semester:III (Tiga)
Major:
Course / Training
computer courses
Place / Insitution
Gunungsitoli, Nias
Remark
Activities /
Organization
Organizat
ion
Scop
Positio
n
Hel
Responsibilities
Company
Position
Held
Responsiblities
SPECIAL AWARD
Please mention award(s) you have been received and explain it briefly
(academic honors, distinction, scholarship, etc)
Yea
r
Awar
d
Institution
Remar
ks
PERSONAL EVALUATION
What make you different from others?
what makes me different from others is, I have a personality that is concerned with the environment and
society. and have high self confidence and more independence. Optimistic and not willing to give up more
easily because the principles that I apply to myself is " never give up ".
NO
st
Program ?
University information
board Friends / relatives
www.astra.co.id
other internet (facebook, email, mailing list, ......................)
Jakarta, ., 2011
(_______________________)
Signature & Full name
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