CONTOH FORMULIR PENDAFTARAN SANTRI ATAU SISWA

MADRASAH KULIYYATUL ISLAMY Jonggrangan, Sumberadi, Mlati, Sleman, Yogyakarta.                     Telepon. .......................................

FORMULIR PENDAFTARAN

Nomor Daftar : ............./DF.UA/........../...............( Diisi petugas)

A. BIODATA SISWA

            A1. Nama Lengkap                 : ................................................................                             

            A2. Tempat, tanggal Lahir      : .................................................................

            A3. Alamat                               : ..................................................................       

            A4. Jenis Kelamin                  : laki-laki / perempuan.*

            A5. Jenjang Pendidikan         : kelas………………………

            A6. Asal Sekolah                    : ...............................................                                                                                  

           

B. BIODATA WALI SISWA

            B1. Nama Ayah                                  : ................................................................

                        B11. Pekerjaan                       : ................................................................

                        B12. Tempat, Tanggal Lahir   : ................................................................

                        B13. Alamat                            : ................................................................

                                                                          ................................................................

                        B14. Nomor Telepon              : ................................................................

            B2. Nama Ibu                                      : ................................................................

                        B21.Pekerjaan                        : .................................................................

                        B22. Tempat, Tanggal Lahir   : .................................................................

                        B23. Alamat                            : .................................................................

                                                                          .................................................................

                        B24. Nomor Telepon              : .................................................................

                                                                                                            Sleman, ..................................                                                                                                                                                                                                 

                                                                                                            Wali Siswa,

                                                                                                            .................................................

*Coret yang tidak perlu.                 


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