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FORMULIR PENDAFTARAN
TAHUN AJARAN 2021-2022
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Email
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KETERANGAN CALON SISWA
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Feeder
Siswa Baru
UNIT PENDAFTARAN
KBB
KBK
TKA
TKB
SD I
SD II
SD III
SD IV
SD V
SD VI
SMP VII
SMP VIII
SMP IX
SMA X
SMA XI
SMA XII
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NAMA LENGKAP [ SESUAI AKTE ]
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NAMA PANGGILAN
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JENIS KELAMIN
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Perempuan
Laki-Laki
TEMPAT LAHIR
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TANGGAL LAHIR
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MM
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DD
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YYYY
WARGA NEGARA
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AGAMA
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Katolik
Kristen
Islam
Budha
Hindu
ALAMAT LENGKAP
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TELP.
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HP.
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NAMA IBU
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NAMA AYAH
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EMAIL
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