Kartu Dispen

Nama
: .......................................................
Kelas
: .......................................................
Terlambat/tidak mengikuti pelajaran selama .........
Menit alasan terlambat/ijin :
..................................................................................
..................................................................................
...............................................................................
Mulai jam ke .................. s.d jam ke .......................
Dan diijinkan mengikuti pelajaran mulai jam ke .....
Nama
: .......................................................
Kelas
: .......................................................
..................................................................................
..................................................................................
...............................................................................
Trenggalek, ........................
A.n. Kepala Sekolah
Guru Piket
Trenggalek, ........................
A.n. Kepala Sekolah
Guru Piket
(........................................)
NIP. ...................................
(........................................)
NIP. ...................................
Nama
: .......................................................
Kelas
: .......................................................
..................................................................................
..................................................................................
...............................................................................
Nama
: .......................................................
Kelas
: .......................................................
..................................................................................
..................................................................................
...............................................................................
Trenggalek, ........................
A.n. Kepala Sekolah
Guru Piket
Trenggalek, ........................
A.n. Kepala Sekolah
Guru Piket
(........................................)
NIP. ...................................
(........................................)
NIP. ...................................
Nama
: .......................................................
Kelas
: .......................................................
..................................................................................
..................................................................................
...............................................................................
Nama
: .......................................................
Kelas
: .......................................................
..................................................................................
..................................................................................
...............................................................................
Trenggalek, ........................
A.n. Kepala Sekolah
Guru Piket
Trenggalek, ........................
A.n. Kepala Sekolah
Guru Piket
(........................................)
NIP. ...................................
(........................................)
NIP. ...................................

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