STANDAR ISI
Nama Sekolah
Nama Kepala Sekolah
Alamat
Hari Tanggal
Tahun Pelajaran
: .
: .
: .
: .
: .
No
Komponen Kegiatan
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
18
20
21
22
23
24
25
26
27
Jawaban
Tdk.
Lengkap
Lengkap
Skor
1
Gugus
JUMLAH
Keterangan: Skor 86 100% = Baik Sekali
71 85% = Baik
55 70% = Cukup
55% = Kurang
Skor Maksimum
NILAI
KATAGORI
Kesimpulan :
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Tindak Lanjut :
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Batam,
Kepala Sekolah,
___________________
NIP.
Pengawas Pembina,
D. SUYATNO DILAR,S.Pd
NIP. 19600420 198310 1 002