SMK PADANG PULUT

23000 DUNGUN
TERENGGANU DARUL IMAN.

BORANG MAKLUMAT DIRI PENGAWAS SEKOLAH

1. Nama
.......

......................................................................................................

2. Tingkatan
.......

......................................................................................................

3. No. K/P
:
.............................................................................................................
4. Alamat
.......

......................................................................................................
......................................................................................................
.......

5. No. Telefon :
(R)................................................
(H/P)...............................................
6. Tinggal di asrama:

Ya

Tidak

7. Nama bapa/ ibu/ penjaga:

................................................................................................
8. Pekerjaan
......

......................................................................................................

9. Alamat
......

......................................................................................................

10. No. Telefon :

(R).............................................
(H/P).................................................
11. Pengalaman sebagai pengawas sekolah

(i)

Tahun
...............................................................................................................
......

(ii)

Jawatan ..............................................................................................................
........

*** Saya mengaku bahawa segala butiran yang telah diisi adalah BENAR.
Yang Benar,
.........................................................
(
)