FORMULIR PENDAFTARAN

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FORMULIR PENDAFTARAN

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Nama Lengkap *

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Tempat Lahir *

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Tanggal Lahir *

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DD

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YYYY

Nama Orang Tua/Wali (Ayah) *

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Nama Orang Tua/Wali (Ibu) *

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Alamat *

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Nomor telepon

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Nama Sekolah Asal (SD/MI/Sederajat)

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NPSN Sekolah Asal

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Jenjang

SDN/S

MIN/S

PAKET

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