Kartu

by | Apr 2, 2020 | Uncategorized | 12 comments

PEMERINTAH ACEH

DINAS PENDIDIKAN

SMK NEGERI 1 BIREUEN

Jln. Taman Siswa No. 2 Telp. (0644) 21558, Fax. (0644) 21358 Bireuen

e-Mail : smknegeri1bireuen@yahoo.co.id – website : smkn1bireuen.sch.id

FORMULIR PENDAFTARAN ONLINE PPDB 2020

NOMOR PENDAFTARAN

{id}

Nama Lengkap Calon siswa baru

:

{Nama Lengkap}

Jenis Kelamin

:

{Jenis Kelamin}

NISN (sesuai pada Web Pendataan NISN/aktif}

:

{NISN (sesuai pada Web Pendataan NISN/aktif}}

NIK

:

{NIK}

Tempat Lahir

:

{Tempat Lahir}

Tanggal Lahir

:

{Tanggal Lahir}

Usia Sekarang

:

{Usia Sekarang}

Agama

:

{Agama}

Asal Sekolah

:

{Asal Sekolah}

Tahun Lulus

:

{Tahun Lulus}

Nama Ayah

:

{Nama Ayah}

Nama Ibu

:

{Nama Ibu}

JURUSAN PILIHAN

:

  

PILIHAN PERTAMA

:

{PILIHAN PERTAMA}

PILIHAN KEDUA

:

{PILIHAN KEDUA}

 

Pas Foto

3×4

  

Bireuen, ………………………….. 2020

Calon Peserta didik

 

 

__________________

 

 

 

 

 

 

 

 

 

 

Pertinggal untuk panitia

 

Bukti Pendaftaran

  1. No. Pendaftaran         : {id}
  2. NISN                : {NISN (sesuai pada Web Pendataan NISN/aktif}}
  3. Nama            : {Nama Lengkap}    
  4. SekolahAsal            : {Asal Sekolah}
  5. Program Studi/KompetensiKeahlian yang dipilih :
    1.     {PILIHAN PERTAMA}

    2. {PILIHAN KEDUA}
 

 

 

Bireuen, ……………………… 2020

PANITIA PPDB,

 

 

 

 

________________________

NIP.______________________

 

 

 

 

 

 

 

 

 

 

 

 

 

DATA PRIBADI CALON SISWA

 

Nama Lengkap Calon siswa baru

:

{Nama Lengkap}

Jenis Kelamin

:

{Jenis Kelamin}

NISN

:

{NISN (sesuai pada Web Pendataan NISN/aktif}}

NIK

:

{NIK}

Tempat Lahir

:

{Tempat Lahir}

Tanggal Lahir

:

{Tanggal Lahir}

Usia Sekarang

:

{Usia Sekarang}

Agama

:

{Agama}

Alamat

:

{Alamat}

Dusun

:

{Dusun}

Kelurahan / Desa

:

{Kelurahan / Desa}

Kecamatan

:

{Kecamatan}

Kode Pos

:

{Kode Pos}

Kabupaten

:

{Kabupaten}

Propinsi

:

{Propinsi}

Jenis sekolah Asal

:

{Jenis sekolah Asal}

Asal Sekolah

:

{Asal Sekolah}

Tahun Lulus

:

{Tahun Lulus}

Status Sekolah Asal

:

{Status Sekolah Asal}

Alamat Sekolah Asal

:

{Alamat Sekolah Asal}

Jenis Tempat Tinggal

:

{Jenis Tempat Tinggal}

Jumlah Saudara Kandung

:

{Jumlah Saudara Kandung}

Anak Ke

:

{Anak Ke}

DATA ORANG TUA

  

  

DATA AYAH

  

  

Status

:

{Status}

Nama Ayah

:

{Nama Ayah}

NIK

:

{NIK }

Tempat Lahir

:

{Tempat Lahir }

Tanggal Lahir

:

{Tanggal Lahir }

Agama

:

{Agama}

Pendidikan

:

{Pendidikan }

Pekerjaan

:

{Pekerjaan }

HP

:

{HP }

DATA IBU

  

  

Status

:

{Status}

Nama Ibu

:

{Nama Ibu}

NIK

:

{NIK }

Tempat Lahir

:

{Tempat Lahir }

Tanggal Lahir

:

{Tanggal Lahir }

Agama

:

{Agama}

Pendidikan

:

{Pendidikan }

Pekerjaan

:

{Pekerjaan }

HP

:

{HP }

NILAI RAPOR SMP SEDERAJAT

  

  

1. MATEMATIKA

  

  

SEMESTER III

:

{
MAT. SEMESTER III }

SEMESTER IV

:

{MAT. SEMESTER IV }

SEMESTER V

:

{
MAT. SEMESTER V }

2. BAHASA INDONESIA

  

  

SEMESTER III

:

{B.INDO SEMESTER III}

SEMESTER IV

:

{B.INDO SEMESTER IV}

SEMESTER V

:

{B.INDO SEMESTER V}

3. BAHASA INGGRIS

  

  

SEMESTER III

:

{B.ING SEMESTER III}

SEMESTER IV

:

{B.ING SEMESTER IV}

SEMESTER V

:

{B.ING SEMESTER V}

4. ILMU PENGETAHUAN ALAM

  

  

SEMESTER III

:

{IPA. SEMESTER III}

SEMESTER IV

:

{IPA. SEMESTER IV}

SEMESTER V

:

{IPA. SEMESTER V}

 

 

 

Mengetahui, Orang Tua/wali

 

 

 

 

 

(………………………………………………..)

Bireuen, ………………….. 2020

Calon Peserta didik

 

 

 

 

 

(………………………………………………..)

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