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PENERIMAAN WARGA BELAJAR BARU,PAKET A,B,C PKBM LC
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PKBM LC
Nama Lengkap
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Tempat,Tanggal Lahir
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Alamat
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Jenis Kelamin
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Laki - Laki
Perempuan
Peminatan
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Paket A
Paket B
Paket C
Ijazah Terakhir
SD /Paket A
SMP / Paket B
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Nama Ayah
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Tahun lahir
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Nama Ibu
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Tahun Lahir
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