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Form Input Data Siswa Kelas XII PS/AP
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Nama Lengkap
*
Masukan Nama Lengkap Anda, gunakan kaidah EYD
Your answer
Jenis Kelamin
*
Laki-Laki
Perempuan
NIS
Nomor Induk Siswa
Your answer
Kelas
*
XII PS1
XII PS 2
XII PS 3
XII PS 4
XII AP 1
XII AP 2
XII AP 3
XII AP 4
Agama
*
Islam
kristen Khatolik
Kristen Protestan
Hindu
Budha
Tempat Lahir
*
Your answer
Tanggal Lahir
*
MM
/
DD
/
YYYY
Alamat Rumah
*
Your answer
Mobile Phone
*
No. HP Yang Bisa Dihubungi
Your answer
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