KEMAMPUAN KOGNITIF
Nama : ...........................................................
CATATAN KHUSUS ANAK Kelompok : ...........................................................
Tahun Ajaran : ...........................................................
Nama : ...................................................................................................
Kelompok : ...................................................................................................
Tahun Ajaran : ...................................................................................................
No Keterangan SEMESTER 1
1. Jumlah ketidakhadiran siswa a. Sakit : ........ hari
b. Izin : ........ hari
c. Tanpa keterangan : ........ hari
2. Catatan Khusus
Guru Kelas
Orang Tua/Wali
Jayapura, .....................................
Kepala TK Islam
CAHAYA HATI
KETERANGAN LAIN-LAIN
KETERANGAN DIRI SISWA
Nama : ...................................................................................................
Kelompok : ...................................................................................................
Tahun Ajaran : ................................................................................................... 1. Nama Siswa
a. Nama Lengkap : ...............................................................
No Keterangan SEMESTER 2 b. Nama Panggilan : ...............................................................
1. Jumlah ketidakhadiran siswa a. Sakit : ........ hari 2. Nomor Induk : ...............................................................
b. Izin : ........ hari 3. Jenis Kelamin : ...............................................................
c. Tanpa keterangan : ........ hari 4. Tempat dan Tanggal Lahir : ...............................................................
2. Catatan Khusus 5. Anak ke : ...............................................................
6. Agama : ...............................................................
7. Nama Orang Tua / Wali*
a. Ayah : ...............................................................
3. Catatan keluar dari TKIT Permata Hati Tanggal : b. Ibu : ...............................................................
Karena : 8. Pekerjaan Orang Tua / Wali*
a. ......................................... a. Ayah : ...............................................................
a. ......................................... b. Ibu : ...............................................................
b. ......................................... 9. Alamat Orang Tua / Wali*
a. ......................................... a. Jalan : ...............................................................
4. b. Desa / Kelurahan : ...............................................................
c. Kecamatan : ...............................................................
Guru Kelas d. Kabupaten / Kota : ...............................................................
e. Propinsi : ...............................................................
Tanda tangan, Nama Kepala TK Islam
dan Tanggal Cahaya Hati
.....................................................,............
CAHAYA HATI
JAYAPURA
Nama TK : .....................................................................................
Alamat : .....................................................................................
: .....................................................................................
Desa / Kelurahan : .....................................................................................
Kecamatan : .....................................................................................
Kabupaten / Kota : .....................................................................................
Provinsi : .....................................................................................
KELOMPOK A
..........................................................................................................
CAHAYA HATI
KELOMPOK B
NAMA :
Nomor Induk : ..
Alamat Kantor :
YAYASAN BAITURRAHIM JAYAPURA
JLN. GARUDA KOMPLEKS BTN SKY LINE INDAH KOTARAJA JAYAPURA