BIODATA
CALON PESERTA DIDIK PAUD LIGAR MUNGGARAN
1. Nama : ................................................................................................
2. Nomor Induk : ................................................................................................
3. Temat/ tanggal lahir : ................................................................................................
4. Jenis Kelamin : ................................................................................................
5. Agama : ................................................................................................
6. Alamat : Dusun ............................................. RT. ....... RW. .................
Desa .................................... Kecamatan ...............................
7. Mulai Masuk PAUD ini : ................................................................................................
8. Nama Orang Tua
a. Ayah : ................................................................................................
Tanggal Lahir : ................................................................................................
Pendidikan Terakhir : ................................................................................................
b. Ibu : ................................................................................................
Tanggal Lahir : ................................................................................................
Pendidikan Terakhir : ................................................................................................
9. Alamat Orang Tua : ................................................................................................
10. Pekerjaan Orang Tua : ................................................................................................
11. Wali : ................................................................................................
a. Nama : ................................................................................................
b. Alamat : ................................................................................................
c. Pekerjaan : ................................................................................................
.............................................
Catatan :
Wajib melampirkan :
1. foto kopi akta kelahiran 1 lembar bagi yang sudah memiliki
2. Foto copy kartu keluarga (KK)
3. Foto Copy KTP orang Tua