ASRAMA SMK.

DURIAN MAS
23000 DUNGUN,
TERENGGANU

SULIT
BORANG PENGAKUAN MURID

NO. DAFTAR SEKOLAH

: _________________

Nama

: ________________________________

TING

: ____________ DORM: _____________

Jantina

: ____________

1. Saya seperti nama di atas mengaku telah melakukan kesalahan seperti keterangan dibawah:1.1

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1.2

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1.3

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1.4

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Tandatangan Murid

Tarikh

Tandatangan Warden/ Guru

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