TAMAN PENDIDIKAN AL-QURAN (TPA) NURUL HIDAYAH AL-WASILAH AL-

IDRUSI
Jl.Rajawali Barat Gg. Burung tungku IV. Rt.05/02. Maleber, Andir.
Bandung. Jawa Barat
Hp.081809364789

Formulir Pendaftaran/Registration Form TPA Nurul Hidayah Al-Wasilah Al-Idrusi

A. Biodata Santri/Student Information

1. Nama Lengkap/Full Name : ................................................................

2. Tempat Tanggal Lahir/Place & Date of Birth : ................................................................

3. Alamat/Address : ................................................................

4. Sekolah/School : ................................................................

5. Kelas/Grade : ................................................................

6. Jenis Kelamin/Gender : ................................................................

B. Biodata Orang Tua/Parent Information

1. Nama Ayah/Father’s Name : ................................................................

2. Pekerjaan/Employer : ................................................................

3. Nama Ibu/Mother’s Name : ................................................................

4. Pekerjaan/Employer : ................................................................

5. Alamat/Address : ................................................................

6. No. Telepon/Phone Number : ................................................................

Diterima di tingkat :.................................................................

Biaya pendaftaran :.................................................................

Bandung,.........................

Kepala TPA, Orang Tua(Parent)/Wali Santri

(Nuraeni,S.Pd) (..........................................)