BORANG LAPORAN SALAH LAKU MURID

A. Latarbelakang Kejadian

1. Tarikh : ………………………………………
2. Masa : ………………………………………
3. Tempat Kejadian : ………………………………………………………………….
4. Pihak yang terlibat : …………………………………………………………………..
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B. Laporan Kejadian ( menurut kronologi peristiwa / masa )

1. ……………………………………………………………………………………………

2. ……………………………………………………………………………………………

3. …………………………………………………………………………………………...

4. ……………………………………………………………………………………………

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7. …………………………………………………………………………………………….

8. …………………………………………………………………………………………….

9. …………………………………………………………………………………………….

10. …………………………………………………………………………………………….

C. Tindakan Pihak Sekolah:

1. …………………………………………………………………………………………….

2. …………………………………………………………………………………………….

3. …………………………………………………………………………………………….

4. …………………………………………………………………………………………….

5. ……………………………………………………………………………………………..

Disediakan oleh: disahkan oleh:

…………………………… …………………………….
( ) ( )
HEM / Ketua Guru Disiplin Pengetua
BORANG ADUAN SALAH LAKU MURID

TARIKH: ....................................... HARI :............................................ MASA :.............................

BUTIR-BUTIR KEJADIAN : (masa kejadian, tempat kejadian, dll. )

NAMA PELAPOR: ...............................................................................KELAS:......................

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SAKSI/BUKTI : 1. .........................................................
2. ........................................................
3. .........................................................
4. ........................................................
5. .........................................................
6. ........................................................
7. .........................................................
8. ........................................................

TANDA TANGAN PELAPOR: .................................................................

( )

TINDAKAN : ......................................................................................................................................
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BORANG PENGAKUAN SALAH LAKU MURID

NAMA MURID :.......................................................................................................................

NO. K/P / SURAT BERANAK : …………………………………………………………………….

KELAS :.......................................................................................................................

TARIKH : .........................................

BUTIR PENGAKUAN:

SALAH LAKU : .......................................................................................................

TARIKH KEJADIAN : ............................................................................................

TEMPAT KEJADIAN : ............................................................................................

MASA KEJADIAN : .............................................................................................

Bahawasanya saya seperti nama dan no. K/P atau no. Surat Beranak di atas telah melakukan salah
laku yang tersebut di atas.

Oleh itu, saya dengan rela hati untuk menerima apa juga tindakan disiplin dan hukuman dari pihak
sekolah.

Yang benar,

....................................................
( Nama Murid )

Disahkan oleh : ............................................................

( Guru Besar / Guru Yang Diberi Kuasa)
BORANG KEBENARAN KELUAR SEKOLAH

Saya ................................................................................(ibu bapa/penjaga) No. K/P:……………..

Memohon kebenaran untuk membawa keluar ……………………………………………..................
(anak/jagaan ) saya, kelas :…………………..untuk tujuan;
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Yang benar, Disahkan oleh: …………………..............

(Guru Bertugas/ Guru Kelas)
......................................................... Nama:
(Nama ibu/bapa/penjaga) Tarikh:

Diluluskan : ...........................................................
(T.t Guru Besar & Cop Jawatan)
DAFTAR KEHADIRAN IBU BAPA/PENJAGA

TINGKATAN:

Bil. NAMA IBU BAPA/ NAMA ANAK/JAGAAN TARIKH/ TUJUAN t.t

PENJAGA MASA

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.
 REKOD PEMERIKSAAN MENGEJUT (SPOT-CHECK)

KELAS : TARIKH :....................... MASA:.................... TEMPAT:..................................................

TUJUAN :..............(Pakaian seragam/penampilan diri/barang larangan)..............................................................................
PIHAK YANG MELAKUKAN PEMERIKSAAN : ......(Guru/Pengawas/dll.)................................

Bil. NAMA MURID L/P HASIL PEMERIKSAAN TINDAKAN t.t

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.
REKOD KEHADIRAN POLIS

NAMA PEGAWAI POLIS: ................................................................................................................

JAWATAN : ................................................... JABATAN :.....................................................

DARI : IPK/IPD/POLIS RONDAAN/CAWANGAN KHAS/DLL.

TARIKH : ……………….. MASA :……………..

TUJUAN : …………………………………………………………………………………………..
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CATATAN : …………………………………………………………………………........................
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