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Dapat juga dengan transfer pulsa Rp.10.000,00 ke. No.HP.085228085470 ( No. AS) atau Pulsa Tri No. 08973527659

Setelah mengirim dana atau pulsa harap segera konfirmasi dan sms kan alamat email untuk pengiriman. DAFTAR ANGGOTA GERBANG KENCANA

No. Kode Nama Tempat/Tgl. Lahir Alamat Email No. HP Status pernikahan Pekerjaan Gereja

: ……………………….. ( Diisi oleh Pengasuh ) : …………………………………………………………………………………………. : …………………………………………,…………………………………………….. : ………………………………………………………………………………………… ………………………………………………………………………………………… : ………………………………………………………………………………………… : ……………………………………………………………………………………….. : ……………………………………………………………………………………….. : ……………………………………………………………………………………….. : ………………………………………………………………………………………..

Pasangan yan didambakan: ……………………………………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………………………………. ……………………………………………. Calon Anggota 3


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