{"id":143,"date":"2026-03-02T15:28:01","date_gmt":"2026-03-02T15:28:01","guid":{"rendered":"https:\/\/dekopinbali.online\/kmpbbs\/?p=143"},"modified":"2026-03-02T15:53:51","modified_gmt":"2026-03-02T15:53:51","slug":"formulir-pendaftaran-anggota","status":"publish","type":"post","link":"https:\/\/dekopinbali.online\/kmpbbs\/formulir-pendaftaran-anggota\/","title":{"rendered":"Formulir Pendaftaran Anggota"},"content":{"rendered":"<h5>KOPERASI JASA MULTI PIHAK BALI BANGKIT SEJAHTERA<\/h5>\n<p><b>Kantor Pusat:<\/b><span style=\"font-weight: 400;\"> Jl. Tukad Badung XII, Blok O, No 1 Renon, Denpasar, Bali.<\/span><\/p>\n<h3><b>A. DATA PRIBADI<\/b><\/h3>\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Nama Lengkap<\/b><span style=\"font-weight: 400;\"> (Sesuai KTP) : _______________________________________<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>NIK<\/b><span style=\"font-weight: 400;\"> (No. Induk Kependudukan) : _______________________________________<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Tempat, Tanggal Lahir<\/b><span style=\"font-weight: 400;\"> : _______________________________________<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Alamat Domisili<\/b><span style=\"font-weight: 400;\"> : _______________________________________<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>No. WhatsApp \/ HP<\/b><span style=\"font-weight: 400;\"> : _______________________________________<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Alamat Email<\/b><span style=\"font-weight: 400;\"> : _______________________________________<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Pekerjaan \/ Bidang Usaha<\/b><span style=\"font-weight: 400;\"> : _______________________________________<\/span><\/li>\n<\/ol>\n<h3><b>B. KLASIFIKASI KELOMPOK ANGGOTA<\/b><\/h3>\n<p><i><span style=\"font-weight: 400;\">(Mohon pilih salah satu kelompok yang paling sesuai dengan profil\/kontribusi Anda)<\/span><\/i><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">[ ] <\/span><b>Kelompok Bisnis IT &amp; Internet<\/b><span style=\"font-weight: 400;\"> (Penyedia jasa teknologi\/software\/jaringan)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">[ ] <\/span><b>Kelompok Bisnis Digital Marketing<\/b><span style=\"font-weight: 400;\"> (Praktisi pemasaran\/konten kreatif)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">[ ] <\/span><b>Kelompok Bisnis Sektor Riil &amp; Pasar<\/b><span style=\"font-weight: 400;\"> (Pedagang KBLI 4781\/Petani\/Kuliner)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">[ ] <\/span><b>Kelompok Bisnis Pendidikan<\/b><span style=\"font-weight: 400;\"> (Penyelenggara pelatihan\/workshop)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">[ ] <\/span><b>Kelompok Mitra &amp; Konsumen<\/b><span style=\"font-weight: 400;\"> (Penghubung pasar atau pengguna jasa)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">[ ] <\/span><b>Kelompok Pelopor \/ Inisiator<\/b><span style=\"font-weight: 400;\"> (Khusus Pendiri\/Pengembang Wilayah)<\/span><\/li>\n<\/ul>\n<h3><b>C. KOMITMEN KEUANGAN AWAL<\/b><\/h3>\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Simpanan Pokok<\/b><span style=\"font-weight: 400;\"> : Rp 900.000,- (Dibayar sekali saat masuk)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Simpanan Wajib<\/b><span style=\"font-weight: 400;\"> : Rp 50.000,- (Dibayar setiap bulan)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Simpanan Wajib Khusus<\/b><span style=\"font-weight: 400;\"> : Rp __________ (Opsional, untuk Unit Penyertaan Modal)<\/span><\/li>\n<\/ol>\n<h3><b>D. PERNYATAAN DAN PAKTA INTEGRITAS<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Dengan mengisi formulir ini, saya menyatakan bahwa:<\/span><\/p>\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Setuju untuk mematuhi AD\/ART Koperasi Jasa Multi Pihak Bali Bangkit Sejahtera.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bersedia terlibat aktif dalam ekosistem kolaborasi antar anggota (Sinergi Digital &amp; Sektor Riil).<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Memahami bahwa hak suara saya dihitung berdasarkan sistem Mandat Proporsional kelompok yang saya pilih.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Data yang saya berikan adalah benar dan dapat dipertanggungjawabkan.<\/span><\/li>\n<\/ol>\n<p><b>Denpasar, \/\/ 2026<\/b><\/p>\n<p><i><span style=\"font-weight: 400;\">(Materai Rp 10.000)<\/span><\/i><\/p>\n<p><b>( _________________________ )<\/b><\/p>\n<p><i><span style=\"font-weight: 400;\">Nama Jelas &amp; Tanda Tangan<\/span><\/i><\/p>\n<h3><b>E. LAMPIRAN DOKUMEN<\/b><\/h3>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fotokopi KTP (1 Lembar)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pas Foto 3&#215;4 (2 Lembar)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Profil Singkat Usaha (Khusus Kelompok Bisnis)<\/span><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>KOPERASI JASA MULTI PIHAK BALI BANGKIT SEJAHTERA Kantor Pusat: Jl. Tukad Badung XII, Blok O, No 1 Renon, Denpasar, Bali. A. DATA PRIBADI Nama<\/p>\n","protected":false},"author":1,"featured_media":57,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0,"footnotes":""},"categories":[8,7],"tags":[],"class_list":["post-143","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-keanggotaan","category-sekilas-kami"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Formulir Pendaftaran Anggota - KMP Bali Bangkit Sejahtera<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/dekopinbali.online\/kmpbbs\/formulir-pendaftaran-anggota\/\" \/>\n<meta property=\"og:locale\" content=\"id_ID\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Formulir Pendaftaran Anggota - KMP Bali Bangkit Sejahtera\" \/>\n<meta property=\"og:description\" content=\"KOPERASI JASA MULTI PIHAK BALI BANGKIT SEJAHTERA Kantor Pusat: Jl. 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