FORMULIR PESERTA DIDIK
PENGISIAN DATA MENGGUNAKAN HURUF KAPITAL
TANGGAL (Pengisian formulir) *
MM
/
DD
/
YYYY
DATA PRIBADI
1. NAMA LENGKAP *
Your answer
2. KELAS *
3. NISN *
Your answer
4. NIK/ No. KITAS (Untuk WNA) *
Your answer
5a. JENIS KELAMIN *
5b. TEMPAT LAHIR *
Your answer
6. TANGGAL LAHIR *
MM
/
DD
/
YYYY
7. AGAMA *
8. KEWARGANEGARAAN *
9. BERKEBUTUHAN KHUSUS *
Required
10. ALAMAT JALAN *
Your answer
11. RT *
Your answer
12. RW *
Your answer
13. NAMA DUSUN *
Your answer
14. NAMA KELURAHAN/ DESA *
Your answer
15. KECAMATAN *
Your answer
16. KODE POS *
Your answer
17. TEMPAT TINGGAL *
18. MODA TRANSPORTASI *
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