Section 1 of 4
FORMULIR PPDB SMA NURUL MUSLIM 2024/2025
Pendaftaran dibuka mulai April - Juli 2024
DATA PRIBADI
DATA PRIBADI
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NAMA LENGKAP
NAMA LENGKAP
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JENIS KELAMIN
JENIS KELAMIN
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NIK (Lihat di Kartu Keluarga)
NIK (Lihat di Kartu Keluarga)
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NOMOR KK (Lihat di Kartu Keluarga)
NOMOR KK (Lihat di Kartu Keluarga)
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TEMPAT TANGGAL LAHIR
TEMPAT TANGGAL LAHIR
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NOMOR REGISTRASI AKTA LAHIR (Lihat di Akta Kelahiran)
NOMOR REGISTRASI AKTA LAHIR (Lihat di Akta Kelahiran)
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AGAMA
AGAMA
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ALAMAT
Desa Dukuh, RT, RW, Kecamatan
Desa Dukuh, RT, RW, Kecamatan
ALAMAT
Desa Dukuh, RT, RW, Kecamatan
Desa Dukuh, RT, RW, Kecamatan
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ANAK KE BERAPA DALAM KELUARGA?
ANAK KE BERAPA DALAM KELUARGA?
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STATUS ANAK DALAM KELUARGA
STATUS ANAK DALAM KELUARGA
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ASAL SEKOLAH SMP/MTs
ASAL SEKOLAH SMP/MTs
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ALAMAT SEKOLAH (DESA)
ALAMAT SEKOLAH (DESA)
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Section 2 of 4
DATA ORANGTUA
NAMA AYAH
NAMA AYAH
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NIK AYAH
(Lihat di Kartu Keluarga)
NIK AYAH
(Lihat di Kartu Keluarga)
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PEKERJAAN AYAH
PEKERJAAN AYAH
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NOMOR WA AYAH
NOMOR WA AYAH
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NAMA IBU
NAMA IBU
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NIK IBU
(Lihat di Kartu Keluarga)
NIK IBU
(Lihat di Kartu Keluarga)
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PEKERJAAN IBU
PEKERJAAN IBU
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NOMOR WA IBU
NOMOR WA IBU
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Section 3 of 4
DATA RINCI SISWA
NOMOR WA SISWA
NOMOR WA SISWA
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EMAIL
EMAIL
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TINGGI BADAN
TINGGI BADAN
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BERAT BADAN
BERAT BADAN
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LINGKAR KEPALA
LINGKAR KEPALA
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JUMLAH SAUDARA KANDUNG
JUMLAH SAUDARA KANDUNG
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HOBI
HOBI
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CITA-CITA
CITA-CITA
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Section 4 of 4
Mohon nanti datang ke SMA Nurul Muslim Batealit untuk mengumpulkan berkas pendaftaran berupa:
1. Foto kopi akta kelahiran
2. Foto kopi KK
3. Foto kopi KTP Bapak 3 lembar dan Foto kopi Ibu 3 lembar
4. Foto kopi KIP/PKH/KKS 1 lembar (jika punya)
5. Foto kopi Rapor kelas IX semester ganjil 1 lembar
6. Mengumpulkan Akta kelahiran ASLI
2. Foto kopi KK
3. Foto kopi KTP Bapak 3 lembar dan Foto kopi Ibu 3 lembar
4. Foto kopi KIP/PKH/KKS 1 lembar (jika punya)
5. Foto kopi Rapor kelas IX semester ganjil 1 lembar
6. Mengumpulkan Akta kelahiran ASLI
APAKAH DATA SUDAH BENAR?
APAKAH DATA SUDAH BENAR?
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