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Formulir Pendaftaran MTs/SMA MARDHATILLAH
A. DATA SISWA/I
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Nama Lengkap
Your answer
Nama Panggilan
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Mendaftar di
*
Choose
MTs Mardhatillah (Putra-Putri)
SMA Mardhatillah (Khusus Putri)
Sekolah Asal
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Alamat Sekolah Asal
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Jenis Kelamin
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Laki-laki
Perempuan
Tempat Lahir
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Tanggal Lahir
MM
/
DD
/
YYYY
Agama
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Kewarganegaraan
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WNI
WNA
Anak ke-
(isi angka)
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Jumlah Saudara Kandung
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Jumlah Saudara Tiri
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Jumlah Saudara Angkat
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Status Anak
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Anak Kandung
Anak Tiri
Lain-lain
Bahasa Sehari-hari
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Alamat
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Nomor Telepon/HP
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Golongan Darah
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A
B
AB
O
Penyakit yang Pernah Diderita
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Kelainan Fisik
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Tinggi
cm
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Berat Badan
kg
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Tanggal dan Nomor Ijazah
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Tanggal dan No. SKHUN
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Hobi
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