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50598630 Instrumen Monitoring Penerimaan Dan Orientasi Peserta Didik SD MI RA TK

50598630 Instrumen Monitoring Penerimaan Dan Orientasi Peserta Didik SD MI RA TK

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KEMENTERIAN AGAMA

KELOMPOK KERJA PENGAWAS PAI (POKJAWAS PAI)
KANTOR KABUPATEN CILACAP
Alamat : Jalan DI. Panjaitan No.44 Telp. (0282)531155 Cilacap
PEMANTAUAN PENERIMAAN DAN ORIENTASI PESERTA DIDIK BARU TK/RA
Nama Sekolah/Madrasah : ...................................................... Wilayah Binaan : ..........................................................
Nama Kepala Sekolah/Madrasah : ...................................................... Kecamatan : ...........................................................
Alamat Sekolah/Madrasah : ...................................................... Kabupaten : Cilacap
Hari !an""al Super#isi : ...................................................... $ropinsi : %a&a !en"ah
N'. K'M$'N(N
%AWABAN N)*A)
K(!.
A+A !)+AK A B C + (
Nilai
A , -. / 011
B , 20 / -3
C , 3. / 21
+ , 40 / 33
( , 0 / 41
Skor
A , 3
B , 4
C , 5
+ , 6
( , 0
A. PENERIMAAN SISWA BARU
0. SK $anitia
6. $en"umuman $$+B
5. $enerimaan $+B / 7ormulir Ad80
4. +a9tar Calon $+B / Buku Ad86
3. Seleksi Calon $+B
.. $en"umuman Hasil Seleksi $+B
2. +a9tar Andik Baru / Buku Ad85
-. *aporan $+B yan" diterima
B. ORIENTASI SISWA BARU
0. $erkenalan den"an teman8teman
6. $erkenalan den"an "uru8"uru
5. $en"enalan %ad&al $ela:aran
4. 'bser#asi *in"kun"an Sekolah
3. $en"enalan !ata !ertib Kelas/Sekolah/Madrasah
.. $en"enalan ;pacara Bendera
J U M L A H
Nilai rata8rata : 100
5 14
B A Nilai Jumlah
×
×
+
Kesimpulan : .....................................................................................................
.....................................................................................................
.....................................................................................................
Saran8saran : .....................................................................................................
.....................................................................................................
.....................................................................................................
Kepala <A ..................................
==============================
N)$: .............................................
Cilacap ............................................
$en"a&as
....................................................
N)$: .......................................................
N'. K'M$'N(N
%ml Semua $> Non $>
* $ * $ * $
0 Calon Sis&a Baru yan" Menda9tar
6 Calon Sis&a Baru yan" +iterima
5 Calon Sis&a Baru yan" !idak +iterima
KEMENTERIAN AGAMA
KELOMPOK KERJA PENGAWAS PAI (POKJAWAS PAI)
KANTOR KABUPATEN CILACAP
Alamat : Jalan DI. Panjaitan No.44 Telp. (0282)531155 Cilacap
PEMANTAUAN PENERIMAAN DAN ORIENTASI PESERTA DIDIK BARU
Nama Sekolah/Madrasah : ...................................................... Wilayah Binaan : ...........................................................
Nama Kepala Sekolah/Madrasah : ...................................................... Kecamatan : ...........................................................
Alamat Sekolah/Madrasah : ...................................................... Kabupaten : Cilacap
Hari !an""al Super#isi : ...................................................... $ropinsi : %a&a !en"ah
N'. K'M$'N(N
%AWABAN N)*A)
K(!.
A+A !)+AK A B C + (
Nilai
A , -. / 011
B , 20 / -3
C , 3. / 21
+ , 40 / 33
( , 0 / 41
Skor
A , 3
B , 4
C , 5
+ , 6
( , 0
A. PENERIMAAN SISWA BARU
0. SK $anitia
6. $en"umuman $$+B
5. $enerimaan $+B/7ormulir S80
4. +a9tar Calon $+B/Buku S86
3. Seleksi $+B
.. $en"umuman Hasil Seleksi $+B
2. +a9tar $+B Kelas ) / Buku S85
-. *aporan $+B yan" diterima
B. ORIENTASI SISWA BARU
0. $erkenalan den"an teman8teman
6. $erkenalan den"an "uru8"uru
5. $en"enalan %ad&al $ela:aran
4. 'bser#asi *in"kun"an Sekolah/Madrasah
3. $en"enalan !ata !ertib Sekolah/Madrasah
.. $en"enalan ;pacara Bendera
J U M L A H
Nilai rata8rata : 100
5 14
B A Nilai Jumlah
×
×
+
Kesimpulan : .....................................................................................................
.....................................................................................................
.....................................................................................................
Saran8saran : .....................................................................................................
.....................................................................................................
.....................................................................................................
Kepala S+/M) ..................................
==============================
N)$: .............................................
Cilacap ............................................
$en"a&as
.....................................................
N)$: .........................................................
N'. K'M$'N(N
%ml Semua !K Non !K
* $ * $ * $
0 Calon Sis&a Baru yan" Menda9tar
6 Calon Sis&a Baru yan" +iterima
5 Calon Sis&a Baru yan" !idak +iterima

....................... 8. Cilacap Jawa Tengah NILAI C D KET.................... 3................................ Panjaitan No. ............................................... Jml Semua L P .. NIP: ...................... 2... ................................... 1................... (0282)531155 Cilacap PEMANTAUAN PENERIMAAN DAN ORIENTASI PESERTA DIDIK BARU Nama Sekolah/Madrasah : Nama Kepala Sekolah/Madrasah : Alamat Sekolah/Madrasah : Hari.... ...................................... ....................................................... B.............................................................................. .... 3............................ Cilacap........................... ........................................ A............... 1 2 3 KOMPONEN Calon Siswa Baru yang Mendaftar Calon Siswa Baru yang Diterima Calon Siswa Baru yang Tidak Diterima ............. 6............... 4........... 1............................................................... 2..................................................................................................... TK L P Non TK L P NO..................................... ....... ........ 4................ 6. KOMPONEN PENERIMAAN SISWA BARU SK Panitia Pengumuman PPDB Penerimaan PDB/Formulir S-1 Daftar Calon PDB/Buku S-2 Seleksi PDB Pengumuman Hasil Seleksi PDB Daftar PDB Kelas I / Buku S-3 Laporan PDB yang diterima ORIENTASI SISWA BARU Perkenalan dengan teman-teman Perkenalan dengan guru-guru Pengenalan Jadwal Pelajaran Observasi Lingkungan Sekolah/Madrasah Pengenalan Tata Tertib Sekolah/Madrasah Pengenalan Upacara Bendera JUMLAH JAWABAN ADA TIDAK A B E Nilai A = B = C = D = E = Skor A = B = C = D = E = 86 – 100 71 – 85 56 – 70 41 – 55 1 – 40 5 4 3 2 1 Nilai rata-rata Kesimpulan : : Jumlah Nilai A + B × 100 14× 5 ..........................KEMENTERIAN AGAMA KELOMPOK KERJA PENGAWAS PAI (POKJAWAS PAI) KANTOR KABUPATEN CILACAP Alamat : Jalan DI............................................................................................... 5.......................... ....................................44 Telp............................... ......................................................................................... ..................... Tanggal Supervisi : NO... Wilayah Binaan Kecamatan Kabupaten Propinsi : : : : ........................... 7........................................... Pengawas ______________________________ NIP: ................. 5........... Saran-saran : Kepala SD/MI .......

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