Name *Alamat Email *Nama Jalan *Apartment, suite, dllKotaPropinsiKode PosNegara AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemen Arab Rep.Yemen DemocraticZambiaZimbabweNo HP/WA *Nomor E-KTA *Lampirkan bukti Kepengurusan *Choose FileNo file chosenDelete uploaded fileSK Kepengurusan DPP maupun DPD minimal 2 Tahun berjalanDPD Asal *--Pilih DPD--DPD ACEH (01)DPD SUMUT (02)DPD SUMBAR (03)DPD RIAU (04)DPD KEPRI (06)DPD SUMSEL (07)DPD BENGKULU (09)DPD LAMPUNG (10)DPD DKI JAKARTA (11)DPD JABAR (12)DPD BANTEN (13)DPD JATENG (14)DPD DIY (15)DPD JATIM (16)DPD BALI (17)DPD NTB (18)DPD KALSEL (22)DPD KALTIM (23)DPD KALTARA (24)DPD SULUT (25)DPD SULTRA (28)DPD SULSEL (29)DPD MALUT (32)DPD PAPUA (33)DPC Asal *Upload file *Drag and Drop (or) Choose Files3 File wajib di upload ( Foto 4 X 6, Surat Pernyataan kesediaan, Visi dan Misi ) sesuai format yang telah ditentukan.Validasi *SetujuDengan mengklik bidang ini saya setuju terhadap ketentuan yang berlaku di Pelaksanaan Munas II Apitu Indonesia, tunduk terhadap aturan AD/ART Apitu Indonesia. Telah memahami persyaratan yang ditentukan oleh Panitia Munas II Apitu Indonesia.DAFTAR CALON KETUA UMUM
