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Form Input Data Siswa XII PS dan AP
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Nama Lengkap
*
Diisi dengan nama lengkap Anda, gunakan kaidah EYD
Your answer
Jenis Kelamin
*
Laki-laki
Perempuan
Required
Agama
Islam
Kristen Katholik
Kristen Protestan
Hindu
Budha
NIS
*
Nomor Induk Siswa
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Kelas
*
Kelas Anda saat ini
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XIIPS1
XIIPS2
XIIPS3
XIIPS4
XIIAP1
XIIAP2
XIIAP3
XIIAP4
Tempat Lahir
*
Your answer
Tanggal Lahir
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MM
/
DD
/
YYYY
Mobile Phone
No. HP yang bisa dihubungi
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Alamat
Alamat Lengkap Anda
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