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FORM PENDAFTARAN PONDOK AL ISHLAH
Formulir resmi secara elektronik untuk pendaftaran calon santri putra dan putri Pondok Pesantren AL ISHLAH
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https://sites.google.com/view/ponpesalishlah/home
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* Indicates required question
Nama siswa (berdasarkan dokumen kependudukan)
*
Your answer
Jenis Kelamin
*
Laki Laki
Perempuan
Required
NISN
Your answer
Tempat Lahir
Your answer
Tanggal Lahir
*
MM
/
DD
/
YYYY
NIK (sesuai kartu keluarga)
*
Your answer
Agama
Your answer
Kebutuhan Khusus
Your answer
Alamat
Your answer
RT
Your answer
RW
Your answer
Dusun
Your answer
Kelurahan
Your answer
Kecamatan
Your answer
Kode Pos
Your answer
Saat ini tinggal bersama
Orang Tua
Wali
Nomor Telpon Utama
*
Your answer
Nomor Telepon lainnya
Your answer
Nomor Peserta UN
*
Your answer
Penerima Kartu Indonesia Pintar (KIP)
Ya
Tidak
Nomor KIP (Diisi jika sebagai penerima KIP)
Your answer
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