Identitas Peserta Didik Kosong.docx

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IDENTITAS PESERTA DIDIK

1.

Nama Peserta Didik

:

2.

Nomor Induk

:

3.

Jenis Kelamin

:

4.

Tempat, Tanggal Lahir

:

5.

Agama

:

6.

Alamat Peserta didik

:

7.

Sekolah Asal:

8.

9.

a. Nama Sekolah

:

b. Alamat

:

Ijazah a. Tahun

:

b. Nomor

:

Diterima di sekolah ini

X (sepuluh)

a. Di Kelas

: ..............................................................................................

b. Pada Tanggal

: 14 Juli 2014

10. Nama Orang Tua : a. Ayah

:

b. Ibu

:

11. Alamat Orang Tua

:

12. Pekerjaan Orang Tua

:

13. Nama Wali

:

14. Alamat Wali

: Telp. .....................................................................................

15. Pekerjaan Wali

:

Bandar Lampung, 14 Juli 2014 Kepala SMK Penerbangan,

Suprihatin, S.Pd

NIP. 100001

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