FORMULIR PENERIMAAN PESERTA DIDIK BARU SMA KRISTEN 1 SALATIGA
FORMULIR PPDB SMA KRISTEN 1 SALATIGA
NAMA SISWA *
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NIK
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No. Induk Siswa Nasional (NISN)
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Tempat Lahir *
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Tanggal lahir *
MM
/
DD
/
YYYY
Jenis Kelamin *
Golongan Darah
Agama *
Penerimaan KPS (Dibuktikan dengan foto kopi Kartu Perlindungan Sosial)
Alamat Email
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Alamat Peserta Didik Baru
Jalan *
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RT / RW *
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Kelurahan *
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Kecamatan *
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No. Telephone / HP
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Kode Pos
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No. Telphone / HP. Peserta Didik Baru
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Asal SMP/MTS *
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Data Prestasi Peserta Didik Baru
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Data Orang Tua
Nama Ayah *
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Tanggal Lahir
MM
/
DD
/
YYYY
Pekerjaan
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Pendidikan
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Penghasilan per Bulan
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Nama Ibu *
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Tanggal Lahir
MM
/
DD
/
YYYY
Pendidikan
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Penghasilan per Bulan
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Alamat Orang Tua
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No. Telphone / HP Orang Tua
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Data Wali
Nama Wali
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Tanggal Lahir
MM
/
DD
/
YYYY
Pekerjaan
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Penghasilan per Bulan
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Alamat Wali
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No. Telphone / HP Wali
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