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FORMULIR PENDAFTARAN SMK ISLAMIYAH WERU TAHUN 2015
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Nama Pembawa
menggunakan huruf kapital
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Nama Lengkap Siswa
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menggunakan huruf kapital
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Jenis Kelamin
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Laki-Laki
Perempuan
Tempat Tanggal Lahir
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Agama
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Alamat Lengkap
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Kode Pos
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Telepon/HP
*
Jika tidak punya masukan nomor HP saudara atau tetangga
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Email / Facebook / PIN BB
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No. KPS / KIP / KKS
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Asal SMP
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Alamat Sekolah Asal
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NISN
*
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No. Peserta UN SMP
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Tahun SKHUN
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Tahun Ijazah
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Nomor SKHUN
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Nomor Ijazah
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Nilai Ujian Nasional
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Nama Ayah
*
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Usia
*
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Pekerjaan
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Nama Ibu
*
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Usia
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Pekerjaan
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Nama Wali
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Usia
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Pekerjaan
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Jumlah Anak
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Anak Ke
*
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Rata-rata penghasilan orang tua per bulan
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Program Keahlian 1
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pilihan pertama
Teknik Audio Video (Elektronika)
Teknik Pengelasan (Mesin)
Teknik Kendaraan Ringan (Otomotif)
Program Keahlian 2
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pilihan kedua
Teknik Audio Video (Elektronika)
Teknik Pengelasan (Mesin)
Teknik Kendaraan Ringan (Otomotif)
Tinggi Badan
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Berat Badan
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Ukuran Baju
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Ukuran Celana
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Ukuran Sepatu
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Minat & Bakat
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yang dipilih adalah benar-benar minat & bakat siswa
Broadcasting (Penyiar Radio, Presenter, Kameramen, Reporter)
Pencak Silat
Tenis Meja
Paduan Suara
Paskibra
Membatik
Seni Musik (Group Band)
Marawis
Seni Lukis
Sepak Bola
Bulu Tangkis
BTQ (Baca Tulis Al Qur'an)
Pecinta Alam
Volly Ball
Belum Memilih
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