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Formulir Pendaftaran Penerimaan Peserta Didik Baru Tahun Pelajaran 2017/2018
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* Indicates required question
No. Urut Pendaftaran
*
Contoh : 17-18-001
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Tanggal Pendaftaran
Contoh : 01 Juli 2017
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No. Ruang
*
Your answer
No. Peserta Ujian SD
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Contoh : 35-001-001-9
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Zonasi
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Choose
1 Kecamatan dan Kawedanan/Komwil
2 Kabupaten Tegal
3 Luar Kabupaten
Nama Lengkap Peserta
*
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Tempat, Tanggal Lahir
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Contoh : Tegal, 01 April 2000
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Jenis Kelamin
*
Choose
Laki-laki
Perempuan
Nama Sekolah Asal
*
Your answer
Kecamatan Sekolah Asal
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Kabupaten Sekolah Asal
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NISN
*
Menggunakan tanda petik (')
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Nilai UASBN SD/MI Bahasa Indonesia
*
Your answer
Nilai UASBN SD/MI Matematika
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Nilai UASBN SD/MI IPA
*
Your answer
Jumlah Nilai UASBN SD/MI
*
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Bonus Prestasi Tertinggi
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Bonus MDA/Pendidikan Keagamaan Non Islam
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Agama
*
Choose
Islam
Protestan
Kalotik
Hindu
Budha
Lainnya
Alamat Calon Peserta Didik
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Kecamatan Alamat Calon Peserta Didik
*
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Nama Ayah
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Pekerjaan Ayah
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Nama Ibu
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Pekerjaan Ibu
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Alamat Orang Tua
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Nama Wali
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Hubungan Wali dengan Calon Peserta
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Pekerjaan Wali
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Alamat Wali
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No. HP Yang bisa dihubungi
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Validasi Berkas
SKHUS Asli
Foto Copy Akte Kelahiran
Foto Copy Kartu Keluarga
Foto Copy Piagam/Setifikat/Sejenisnya
Foto Copy Ijazah MDA dan Buku Induk/Keagamaan Non Islam
Foto Copy Kartu NISN
Foto Copy Kartu PIP
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