BERITA ACARA

MONITORING PENYELENGGARAAN
UJIAN SEMESTER GANJIL MADRASAH IBTIDA’IYAH
TAHUN PELAJARAN 2015-2016

Pada hari ini , ................................ tanggal ...................... Bulan Desember 2015 telah dilaksanakan monitoring
ke Madrasah Peyelenggara Ujian Semester Ganjil Madrasah Ibtida’iyah Kabupaten Lamongan Tahun Pelajaran
2015 – 2016 oleh Tim Monitoring Ujian Semester Ganjil Madrasah Ibtida’iyah.

Nama Anggota Tim : Drs.H.M. Chudlori

Alamat : Kalitengah
Diterima oleh : Kepala Mi
Nama Madrasah : ....................................................................................
Alamat Madrasah : ....................................................................................

INSTRUMEN MONITORING

A. ADMINISTRASI PELAKSANAAN UJIAN SEMESTER GANJIL MI

1. SK. Kepanitiaan : ...................................................................................
2. Daftar Nominasi Peserta : ...................................................................................
3. Jadwal Pengawas : ...................................................................................
4. Daftar Hadir Pengawas : ...................................................................................
5. Denah Ruang : ...................................................................................
6. Denah Tempat Duduk Peserta : ...................................................................................
7. Nomor Peserta Di Bangku : ...................................................................................
8. Daftar Hadir Peserta : ...................................................................................
9. Kartu Peserta Ujian : ...................................................................................

B. PELAKSANAAN UJIAN SEMESTER GANJIL MI

1. Jumlah Peserta : Laki-laki = ............. Siswa, Perempuan = ................... Siswa
Jumlah = .................... siswa
2. Jumlah Peserta Tiap Ruang : 1. Ruang Besar ............................. Siswa
2. Ruang Kecil ............................... Siswa
3. Jumlah peserta tidak hadir : 1. Sakit ................................ Siswa
2. Keterangan lain .......................... Siswa
4. Waktu Pelaksanaan : Pagi / Siang
5. Jumlah pengawas tiap ruang : .......................................................... Orang
6. Silang dengan : MI..............................................................................................
7. Suasana pelaksanaan : baik- cukup – kurang
8. Keadaan ruang ujian : baik – cukup – kurang

C. CATATAN PELAKSANAAN UJIAN SEMESTER GANJIL

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Lamongan, ............................ Desember 2015

Kepala Madrasah Petugas Monitoring

____________________________ Drs. H. M. Chudlori

NIP . 195705051980031008