Permohonan Menjadi Anggota RM_StatsNama LengkapNama PanggilanTempat & Tanggal LahirNo.KTPJenis Kelamin Laki Laki Perempuan Nama Ibu KandungSuku/EtnisStatus Pernikahan Menikah Belum/Tidak Menikah Duda/Janda Pekerjaan ASN POLRI/TNI Wiraswasta Pedagang Nelayan Rohaniawan Honorer Pelajar/Mahasiswa Peternak Pensiunan Karyawan Swasta Lainnya Agama Katolik Kristen Islam Hindu Budha Kong Hu Chu Pendidikan Terakhir Tidak Sekolah SD SMP SMA S1 S2 AlamatNo.Tlp/HpPassword *Password must be at least 7 characters long.Enter password again *Password must be at least 7 characters long.Username *Email *Tempat Pelayanan TP. Makassar TP. Sungguminasa TP. Tobadak TP. Baras TP. Messawa Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.
