Nama : ................................................................ Nama : ................................................................
Tempat, Tanggal Lahir : ................................................................ Tempat, Tanggal Lahir : ................................................................ Asal SMP : ................................................................ Asal SMP : ................................................................ Alamat : ................................................................ Alamat : ................................................................ ................................................................ ................................................................ Nama Orang Tua : 1. ............................................................ Nama Orang Tua : 1. ............................................................ 2. ............................................................ 2. ............................................................ Pekerjaan Orang Tua : 1. ............................................................ Pekerjaan Orang Tua : 1. ............................................................ 2. ............................................................ 2. ............................................................ Cabang Olahraga : ................................................................ Cabang Olahraga : ................ ................................................
Denah Rumah dari SMA N 1 Pundong Denah Rumah dari SMA N 1 Pundong