tag:blogger.com,1999:blog-43067786739984435142024-02-08T06:37:33.796-08:00formulirAnonymoushttp://www.blogger.com/profile/11914698518497816098noreply@blogger.comBlogger1125tag:blogger.com,1999:blog-4306778673998443514.post-74501716737194006982012-12-01T04:38:00.003-08:002012-12-01T04:38:18.978-08:00formulir miss indonesia<table align="center" border="0" cellpadding="5" cellspacing="5" style="width: 900px;"><tbody>
<tr><td valign="top" width="40%">Wakil dari propinsi</td>
<td colspan="2" valign="top"><input name="propinsi" size="45" type="text" value="" /></td>
</tr>
<tr>
<td valign="top">Referensi dari</td>
<td colspan="2" valign="top"><input name="referensi" size="45" type="text" value="" /></td>
</tr>
<tr>
<td valign="top">Kota Audisi</td>
<td colspan="2" valign="top"><input name="audisi" size="45" type="text" value="" /></td>
</tr>
<tr>
<td valign="top">Nama Lengkap</td>
<td colspan="2" valign="top"><input name="nama_lengkap" size="45" type="text" value="" /></td>
</tr>
<tr>
<td valign="top">Nama Panggilan</td>
<td colspan="2" valign="top"><input name="nama_panggilan" size="45" type="text" value="" /></td>
</tr>
<tr>
<td valign="top">Usia</td>
<td colspan="2" valign="top"><input name="usia" size="45" type="text" value="" /></td>
</tr>
<tr>
<td valign="top">Tempat & tanggal lahir</td>
<td colspan="2" valign="top"><input name="ttl" size="45" type="text" value="" /></td>
</tr>
<tr>
<td valign="top">Alamat tempat tinggal saat ini</td>
<td colspan="2" valign="top"><input name="alamat" size="45" type="text" value="" /></td>
</tr>
<tr>
<td valign="top">No. Telephone yang mudah dihubungi</td>
<td colspan="2" valign="top"><input name="telp" size="45" type="text" value="" /></td>
</tr>
<tr>
<td valign="top">No. Handphone</td>
<td colspan="2" valign="top"><input name="hp" size="45" type="text" value="" /></td>
</tr>
<tr>
<td valign="top">Email</td>
<td colspan="2" valign="top"><input name="email" size="45" type="text" value="" /></td>
</tr>
<tr>
<td valign="top">Pekerjaan terakhir</td>
<td colspan="2" valign="top"><input name="pekerjaan" size="45" type="text" value="" /></td>
</tr>
<tr>
<td valign="top">Pendidikan terakhir</td>
<td valign="top" width="20%">SMU/Sederajat</td>
<td valign="top" width="40%"><input name="sma" size="20" type="text" value="" /></td>
</tr>
<tr>
<td valign="top"> </td>
<td valign="top">D1/D2/D3</td>
<td valign="top"><input name="d123" size="20" type="text" value="" /></td>
</tr>
<tr>
<td valign="top"> </td>
<td valign="top">S1/S2</td>
<td valign="top"><input name="s12" size="20" type="text" value="" /></td>
</tr>
<tr>
<td valign="top">Alamat sekolah/kampus saat ini, jika ada</td>
<td colspan="2" valign="top"><input name="alamat_sekolah" size="45" type="text" value="" /></td>
</tr>
<tr>
<td valign="top">Kelas/Jurusan</td>
<td colspan="2" valign="top"><input name="kelas_jurusan" size="45" type="text" value="" /></td>
</tr>
<tr>
<td valign="top">Bakat / Kemampuan Khusus</td>
<td colspan="2" valign="top"><input name="hobbi" size="45" type="text" value="" /></td>
</tr>
<tr>
<td valign="top">Prestasi</td>
<td colspan="2" valign="top"><input name="prestasi" size="45" type="text" value="" /></td>
</tr>
<tr>
<td valign="top">Penghargaan</td>
<td colspan="2" valign="top"><input name="penghargaan" size="45" type="text" value="" /></td>
</tr>
<tr>
<td valign="top">Bahasa yang dikuasai</td>
<td colspan="2" valign="top"><input name="bahasa" size="45" type="text" value="" /></td>
</tr>
<tr>
<td valign="top">Nama orang tua/wali</td>
<td valign="top">Ayah</td>
<td valign="top"><input name="ayah" size="20" type="text" value="" /></td>
</tr>
<tr>
<td valign="top"> </td>
<td valign="top">Ibu</td>
<td valign="top"><input name="ibu" size="20" type="text" value="" /></td>
</tr>
<tr>
<td valign="top"> </td>
<td valign="top">Wali</td>
<td valign="top"><input name="wali" size="20" type="text" value="" /></td>
</tr>
<tr>
<td valign="top">Alamat tempat tinggal orang tua</td>
<td colspan="2" valign="top"><input name="alamat_ortu" size="45" type="text" value="" /></td>
</tr>
<tr>
<td class="ungu" valign="top">Ukuran kemeja</td>
<td colspan="2" valign="top"><label>
<input name="kemeja" type="radio" value="S" />
S </label>
<label>
<input name="kemeja" type="radio" value="M" />
M </label>
<label>
<input name="kemeja" type="radio" value="L" />
L </label>
</td>
</tr>
<tr>
<td class="ungu" valign="top">Ukuran t-shirt</td>
<td colspan="2" valign="top"><label>
<input name="tshirt" type="radio" value="S" />
S </label>
<label>
<input name="tshirt" type="radio" value="M" />
M </label>
<label>
<input name="tshirt" type="radio" value="L" />
L </label>
</td>
</tr>
<tr>
<td class="ungu" valign="top">Tinggi badan</td>
<td colspan="2" valign="top"><input name="tinggi" size="45" type="text" value="" />
cm</td>
</tr>
<tr>
<td class="ungu" valign="top">Berat badan</td>
<td colspan="2" valign="top"><input name="berat" size="45" type="text" value="" />
kg</td>
</tr>
<tr>
<td class="ungu" valign="top">Ukuran celana panjang</td>
<td colspan="2" valign="top"><input name="ukuran_celana" size="45" type="text" value="" /></td>
</tr>
<tr>
<td class="ungu" valign="top">Ukuran sepatu</td>
<td colspan="2" valign="top"><input name="ukuran_sepatu" size="45" type="text" value="" /></td>
</tr>
<tr>
<td class="ungu" valign="top">Lingkar dada</td>
<td colspan="2" valign="top"><input name="dada" size="45" type="text" value="" /></td>
</tr>
<tr>
<td class="ungu" valign="top">Lingkar pinggul</td>
<td colspan="2" valign="top"><input name="pinggul" size="45" type="text" value="" /></td>
</tr>
<tr>
<td class="ungu" valign="top">Lingkar pinggang</td>
<td colspan="2" valign="top"><input name="pinggang" size="45" type="text" value="" /></td>
</tr>
<tr>
<td colspan="3" valign="top">Melampirkan photo dengan 4 versi dan tidak menggunakan lensa soft focus ukuran 4R (Upload photo maksimal 250 kb)</td>
</tr>
<tr>
<td valign="top">Close up tampak depan</td>
<td valign="top"><img alt="close up tampak depan" border="0" src="http://www.rcti.tv/public/assets/missindonesia/sample/2013/half-front-kecil.jpg" /></td>
<td valign="top"><input name="depan" size="15" type="file" /></td>
</tr>
<tr>
<td valign="top">Close up tampak samping</td>
<td valign="top"><img alt="close up tampak samping" border="0" src="http://www.rcti.tv/public/assets/missindonesia/sample/2013/half-side-kecil.jpg" /></td>
<td valign="top"><input name="samping" size="15" type="file" />
</td>
</tr>
<tr>
<td valign="top">Seluruh badan tampak depan</td>
<td valign="top"><img alt="seluruh badan tampak depan" border="0" src="http://www.rcti.tv/public/assets/missindonesia/sample/2013/full-front-kecil.jpg" /></td>
<td valign="top"><input name="badan_depan" size="15" type="file" />
</td>
</tr>
<tr>
<td valign="top">Seluruh badan tampak samping</td>
<td valign="top"><img alt="seluruh badan tampak samping" border="0" src="http://www.rcti.tv/public/assets/missindonesia/sample/2013/full-side-kecil.jpg" /></td>
<td valign="top"><input name="badan_samping" size="15" type="file" />
</td>
</tr>
<tr>
<td colspan="3" valign="top"><h2>
Keterangan</h2>
<ul>
<li>Datang langsung ke lokasi audisi mulai pukul 08.00 wib. GRATIS!!</li>
</ul>
</td>
</tr>
<tr>
<td colspan="3" valign="top"><h2>
Persyaratan Peserta</h2>
<ol>
<li>WNI, 17-23 Tahun sebelum 1 September 2013</li>
<li>Belum menikah dan mempunyai anak</li>
<li>Tinggi minimum 167 cm</li>
<li>Memiliki pengetahuan umum dan wawasan luas</li>
<li>Berpenampilan menarik, cantik, cerdas, serta berkeribadian</li>
<li>Menguasai bahasa Inggris atau bahasa asing lain / bahasa Daerah</li>
<li>Mempunyai bakat / keahlian khusus</li>
<li>Mengisi formulir pendaftaran</li>
<li>Sehat jasmani dan rohani</li>
<li>Semua kandidat yang datang di kota audisi berdasarkan seleksi awal panitia</li>
</ol>
</td></tr>
</tbody></table>
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