INSTITUT PENDIDIKAN GURU MALAYSIA

KAMPUS PENDIDIKAN TEKNIK

KUALA LUMPUR
NO. TEL. : 03-91318058/9740/3302/9724
NO. FAKS : 03-91315155

BIODATA
PRAKTIKUM

GURU
1

Nama Guru Pelatih

PELATIH
2

Gambar
Ukuran
pasport

:___________________________________________

Nombor Kad Pengenalan

:___________________________________________

Program

:___________________________________________

Ambilan

:___________________________________________

Subjek Major

:___________________________________________

Subjek Minor

:___________________________________________

Pensyarah Pembimbing Major

:___________________________________________

Pensyarah Pembimbing Minor

:___________________________________________

Guru Pembimbing Minor

:___________________________________________

Guru Pembimbing Minor

Ala
mat Tetap

:___________________________________________
:___________________________________________
:___________________________________________
:___________________________________________

Alamat Menginap

:___________________________________________

(Praktikum)

:___________________________________________
:___________________________________________

Nombor Telefon Bimbit

:___________________________________________

Nombor Telefon Rumah

:___________________________________________

Nombor Telefon Pejabat

:___________________________________________

Bangsa
Jantina
Maklumat dalam simpanan portfolio