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Form Pendaftaran Oriflame
* wajib diisi ya...
1.	Nama *
2.	Tanggal Lahir (dd/mm/yyyy) *
3.	Jenis Kelamin (L/P) *
4.	No KTP / SIM * *
5.	Telp / HP * *
6.	Email *
7.	website / blog
8.	Alamat Rumah * *
9.	Kota * *
10.	Kode Pos
11.	Provinsi * *
12.	Alamat kantor / alternatif
13.	Nama Sponsor (diisi jika ada)
14.	No Sponsor (diisi jika ada)