PT Dataindo Inti Swakarsa
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Data Pribadi
Nama *
Gelar Depan
Contoh : Prof., Dr., Drs., Dra., Ir., ...
Gelar Belakang
Contoh : Phd, MSc, MM, BA, ...
Jenis Kelamin
Pria
Wanita
Tanggal Lahir *
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Januari
Februari
Maret
April
Mei
Juni
Juli
Agustus
September
Oktober
November
Desember
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
Tempat Lahir (Kota, Negara) *
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia-Herzegovina
Botswana
BOUVET ISLAND
Brazil
British Indian Ocean Territory
British Virgin Islands
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Islands
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote D Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faeroe Islands
Falkland Islands (Malvinas)
Fiji
Finland
Former Czechoslavakia
Former USSR (for reference)
France
French Guiana
French Polynesia
FRENCH SOUTHERN TERRITORIES
Gabon
Gambia
Georgia
Germany, Federal Republic of
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
HEARD AND MCDONALD ISLAND
Honduras
Hongkong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic of
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea Democratic Peoples Republic
Korea, Republic of
Kuwait
Kyrgyzstan
Laos Peoples Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Liechtenstein
Lithuania
Luxembourg
Lybian Arab Jamahiriya
Macau
Madagascar
Malagasi
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mexico
Micronesia, Federated States of
Moldova, Republic of
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Islands
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestina
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Republic of Macedonia
Reunion
Romania
Russian Federation
Rwanda
Saint Lucia
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
St Helena
St Kitts-Nevis
St Pierre and Miquelon
St Vincent and Grenadines
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, United Republic of
Thailand
Timor Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Virgin Islands
Uruguay
US Minor Outlying Islands
Uzbekistan
Vanuatu
Vatican City State (Holy See)
Venezuela
Vietnam
Wallis and Futuna Islands
Western Sahara
Yemen
Yugoslavia
Zaire
Zambia
Zimbabwe
Kewarganegaraan
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia-Herzegovina
Botswana
BOUVET ISLAND
Brazil
British Indian Ocean Territory
British Virgin Islands
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Islands
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote D Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faeroe Islands
Falkland Islands (Malvinas)
Fiji
Finland
Former Czechoslavakia
Former USSR (for reference)
France
French Guiana
French Polynesia
FRENCH SOUTHERN TERRITORIES
Gabon
Gambia
Georgia
Germany, Federal Republic of
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
HEARD AND MCDONALD ISLAND
Honduras
Hongkong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic of
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea Democratic Peoples Republic
Korea, Republic of
Kuwait
Kyrgyzstan
Laos Peoples Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Liechtenstein
Lithuania
Luxembourg
Lybian Arab Jamahiriya
Macau
Madagascar
Malagasi
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mexico
Micronesia, Federated States of
Moldova, Republic of
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Islands
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestina
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Republic of Macedonia
Reunion
Romania
Russian Federation
Rwanda
Saint Lucia
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
St Helena
St Kitts-Nevis
St Pierre and Miquelon
St Vincent and Grenadines
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, United Republic of
Thailand
Timor Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Virgin Islands
Uruguay
US Minor Outlying Islands
Uzbekistan
Vanuatu
Vatican City State (Holy See)
Venezuela
Vietnam
Wallis and Futuna Islands
Western Sahara
Yemen
Yugoslavia
Zaire
Zambia
Zimbabwe
Agama *
Status *
Lajang / Single
Menikah / Maried
Pekerjaan
Jabatan*
Nama Perusahaan*
Bidang Usaha*
Masa Kerja
(tahun)
Nomor Kontak
Email*
Telepon Genggam
Telepon Kantor
Telepon Rumah
Faksimil
Alamat Rumah
Jalan dan nomor
Kota
Propinsi
Kode Pos
Financial
Pendapatan per bulan
1 - 2 juta
2 - 5 juta
5 - 10 juta
10 - 20 juta
< 20 juta
Banker 1
Banker 2
Kartu Kredit
Visa
Master
Amex
JCB
Diners
Lainya
Informasi Tambahan
Hobi
Klub Membership
Biografi
Data Pribadi *
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