2014

BORANG MAKLUMAT DIRI PELAJAR

2 HIJAU

1. NAMA :

0 2 / 0 1 / 2 0 1 4
2. JANTINA

: L / P

TARIKH MASUK KELAS :

3. NO. PENDAFTARAN SEKOLAH :

2. NO. KAD PENGENALAN :

/

3. TARIKH LAHIR

4. NO. SIJIL LAHIR

5. TEMPAT LAHIR

: ____________________________________________________________

6. SEKOLAH KEBANGSAAN : _______________________________________________________

7. BIASISWA/BANTUAN : __________________________________________________________
(nyatakan jika ada)
8. JUMLAH BANTUAN : RM ________________________ ( BULANAN / TAHUNAN )
9. NAMA WARIS : _________________________________________________________________
10. ALAMAT

: ________________________________________________________________
________________________________________________________________
________________________________________________________________

11. NO. TELEFON : (R) _____________________________ (P) ___________________________

12. PEKERJAAN WARIS :

_________________________________________________________

13. PENDAPATAN SEBULAN

: RM ____________________

14. BILANGAN ANAK BERSEKOLAH : _______________________

15. RUMAH SUKAN : _______________________
16. AKTIVITI KO-KURIKULUM :

______________________________________________________

_______________________________________________________________________________

19. BUTIRAN KELUARGA / ADIK-BERADIK :

BIL.

NAMA

UMUR

SEKOLAH

BIASISWA

/ INSTITUSI

(sekiranya ada)

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.

20. CATATAN : _____________________________________________________________________

_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

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