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* Panggilan	Ibu.  Bpk.
* Nama Depan & Tengah
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* Alamat Baris 1
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* Kota
Negara Bagian / Wilayah / Provinsi	-- Silahkan pilih (hanya AS / Kan / Aus) - Amerika Serikat --------------------------------- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming - Provinsi Kanada ------------------------ Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Nunavut Ontario Prince Edward Island Québec Saskatchewan Northwest Territories Yukon Territory - Negara Bagian / Wilayah Australia ----------- Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia
* Negara	-- Silahkan Pilih Negara ----------------------------------------- Afghanistan, Islamic Republic of Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentine Republic Armenia Aruba (The Netherlands) Australia Austria Azerbaijan Bahamas, The Bahrain Bangladesh, People's Republic of Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia, Pluinational State of Bonaire, Saint Eustatius and Saba Bosnia and Herzegovina Botswana Brazil British Indian Ocean Territory (United Kingdom) Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands (United Kingdom) Central African Republic Chad Chile China, People's Republic of Christmas Island Cocos (Keeling) Islands Colombia Comoros, Union of the Congo, Democratic Republic of the Congo, Republic of the Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands / Islas Malvinas Faroe Islands Fiji Islands Finland France French Guiana French Polynesia French Southern and Antarctic Lands (France) Gabonese Republic Gambia Georgia Germany Ghana Gibraltar (United Kingdom) Greece Greenland Grenada Guadeloupe (France) Guam (U.S.) Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong S.A.R. (China) Hungary Iceland India Indonesia Iran, Islamic Republic of Iraq Ireland Israel Italy Jamaica Japan Jordan, Hashemite Kingdom of Kazakhstan Kenya Kiribati Korea, Democratic People's Republic of (North Korea) Korea, Republic of (South Korea) Kosovo Kuwait Kyrgyzstan (Kyrgyz Republic) Lao People's Democratic Republic Latvia Lebanon (Lebanese Republic) Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau S.A.R. (China) Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique (France) Mauritania Mauritius Mayotte (France) Mexico Micronesia, Federated States of Moldova Monaco Mongolia Montenegro Montserrat (United Kingdom) Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands, The New Caledonia (France) New Zealand Nicaragua Niger Nigeria Niue (New Zealand) Norfolk Island (Australia) North Macedonia, Republic of Northern Mariana Islands (U.S.) Norway Oman Pakistan Palau Palestinian Territories Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Island Poland Portugal Puerto Rico (U.S.) Qatar Réunion (France) Romania Russian Federation Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon (France) Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (France) Sint Maarten (The Netherlands) Slovak Republic Slovenia Solomon Islands Somali Republic South Africa South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen (Norway) Swaziland Sweden Switzerland Syrian Arab Republic Taiwan, Republic of China Tajikistan Tanzania Thailand Timor-Leste Togolese Republic Tokelau (New Zealand) Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States of America Uruguay Uzbekistan Vanuatu Vatican City State Venezuela, Bolivarian Republic of Vietnam Virgin Islands, British (United Kingdom) Virgin Islands, U.S. Wallis and Futuna Islands Western Sahara Yemen Zambia Zimbabwe
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Informasi Akun
* Nama User	Nama User anda harus terdiri dari setidaknya dua (2) karakter panjangnya. Besar kecilnya huruf berpengaruh.
* Sandi	Sandi harus terdiri dari lima (5) karakter atau lebih dan harus terdiri dari kombinasi huruf dan angka. Besar kecilnya huruf berpengaruh.
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