JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
FORMULIR DAFTAR ULANG SMA NEGERI 1 KAPUAS TIMUR
A. IDENTITAS PESERTA DIDIK BARU
Sign in to Google
to save your progress.
Learn more
* Indicates required question
NAMA
*
Your answer
JENIS KELAMIN
*
LAKI
PEREMPUAN
NIK
*
Your answer
TEMPAT LAHIR (lihat di ijazah)
*
Your answer
TANGGAL LAHIR (lihat di ijazah)
*
MM
/
DD
/
YYYY
NAMA IBU KANDUNG ( di KK/Akte)
*
Your answer
NISN (lihat di Ijazah)
*
Your answer
Asal Sekolah
*
Your answer
AGAMA
*
Your answer
ALAMAT RUMAH (lihat di KK)
*
Your answer
RT
*
Your answer
RW
Your answer
DESA
*
Your answer
KELURAHAN
*
Your answer
KODE POS
*
Your answer
KECAMATAN
*
Your answer
PROVINSI
*
Your answer
TINGGI BADAN
*
Your answer
BERAT BADAN
*
Your answer
JARAK RUMAH KESEKOLAH
*
Your answer
WAKTU TEMPUH
*
Your answer
TEMPAT TINGGAL IKUT DENGAN
*
ORANG TUA
SAUDARA
PAMAN/TANTE
KAKEK/NENE
KOS
ASRAMA
Lainnya
TRANSPORTASI
*
Your answer
ANAK KE
*
1
2
3
4
5
6
7
8
9
10
Lainnya
NOMOR HP
*
Your answer
EMAIL
*
Your answer
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of SMAN 1 Kapuas Timur.
Does this form look suspicious?
Report
Forms
Help and feedback
Help Forms improve
Report
