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Penerimaan Peserta Didik Baru MIS GUPPI CITIUSARI
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* Indicates required question
Nama Calon Siswa
*
Your answer
NIK Calon Siswa
*
Your answer
Tempat Lahir Calon Siswa
*
Your answer
Tanggal Lahir Calon Siswa
*
MM
/
DD
/
YYYY
Jenis Kelamin
*
L
P
KELAS YANG DIINGINKAN
*
1
2
3
4
5
6
Anak ke berapa?
*
Your answer
Alamat sesuai KK
*
Your answer
Nomor KK
*
Your answer
Nama Ayah
*
Your answer
NIK Ayah
*
Your answer
Pendidikan Ayah
*
Tidak Sekolah
SD/MI Sederajat
SMP/MTs Sederajat
SMA/MA/SMK
D1
D2
D3
D4
S1
S2
S3
Pekerjaan Ayah
*
Your answer
Nama Ibu
*
Your answer
NIK Ibu
*
Your answer
Pendidikan Ibu
*
Tidak Sekolah
SD/MI Sederajat
SMP/MTs Sederajat
SMA/MA/SMK
D1
D2
D3
D4
S1
S2
S3
Pekerjaan Ibu
*
Your answer
Penghasilan Kedua Orang Tua Perbulan
*
Your answer
Nomor HP yang bisa dihubungi
*
Your answer
Nomor KKS/KPS (Jika Ada)
Your answer
Nomor PKH (Jika Ada)
Your answer
Nomor KIP (Jika Ada)
Your answer
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