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PPDB ONLINE SMK MUHAMMADIYAH 1 KEMLAGI
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NAMA LENGKAP
*
Your answer
JENIS KELAMIN
Laki-laki
Perempuan
Clear selection
NISN
Your answer
NIK (Nomor Induk Kependudukan )
Your answer
TANGGAL LAHIR
MM
/
DD
/
YYYY
NO REGITRASI AKTA LAHIR
Your answer
AGAMA & KEPERCAYAAN
ISLAM
KRISTEN / PROTESTAN
KATHOLIK
HINDU
BUDHA
KHONGHUCU
ALAMAT JALAN
Your answer
RT/ RW
Your answer
NAMA DUSUN
Your answer
NAMA KELURAHAN / DESA
Your answer
KECAMATAN
Your answer
KODE POS
Your answer
TEMPAT TINGGAL
BERSAMA ORANG TUA
WALI
KOS
ASRAMA
PANTI ASUHAN
LAINNYA
NOMOR KKS
Your answer
ANAK KEBERAPA
Your answer
PENERIMA KPS / PKH
YA
TIDAK
Clear selection
NO. KPS / PKH (apabila menerima)
Your answer
APAKAH PUNYA KIP?
YA
TIDAK
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NOMOR KIP
Your answer
IDENTITAS SEKOLAH
NPSN
Your answer
ASAL SEKOLAH
Your answer
STATUS SEKOLAH
NEGERI
SWASTA
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ALAMAT SEKOLAH
Your answer
DATA AYAH KANDUNG
NAMA AYAH KANDUNG
Your answer
PEKERJAAN
Your answer
PENGHASILAN BULANAN
KURANG DARI 500.000
500.000 - 999.9999
1 JUTA - 1.999.999
2 JUTA - 4.999.999
5 JUTA - 20 JUTA
LEBIH DARI 20 JUTA
BERKEBUTUHAN KHUSUS
YA
TIDAK
DATA WALI
NAMA WALI
Your answer
PEKERJAAN
Your answer
PENGHASILAN BULANAN
KURANG DARI 500.000
500.000 - 999.9999
1 JUTA - 1.999.999
2 JUTA - 4.999.999
5 JUTA - 20 JUTA
LEBIH DARI 20 JUTA
BERKEBUTUHAN KHUSUS
YA
TIDAK
KONTAK
NOMOR TELEPON RUMAH
Your answer
NOMOR HP
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EMAIL
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