JL. Arya Wangsakara. Desa Tapos Kecamatan Tigaraksa Kabupaten Tangerang Banten Telp. (021)5991032 E-mail : man_3raksa@yahoo.co.id
FORMULIR PENDAFTARAAN PENGURUS OSIS
(MASA BAKTI 2019-2020) MAN 1 TANGERANG BIODATA PESERTA : Nama Lengkap :................................................................................................... Nama Panggilan :................................................................................................... Tempat Tanggal Lahir :................................................................................................... Motto Hidup :................................................................................................... Kelas :................................................................................................... Alamat :................................................................................................... No hp/WA :................................................................................................... Email :................................................................................................... Jabatan yang diinginkan :................................................................................................... Alasan masuk OSIS :................................................................................................... .................................................................................................... Hobi :.................................................................................................. IDENTITAS ORANG TUA/WALI MURID : Nama Ayah/Ibu/Wali :................................................................................................... No. Telp :................................................................................................... Alamat :................................................................................................... ....................................................................................................
Dengan mengisi Formulir Pendaftaraan Pengurus OSIS ini, maka saya
secara sadar tanpa paksaan dari pihak manapun, serta atas sepengetahuan dan izin orang tua/wali murid untuk mengikuti Pendaftaraan Pengurus OSIS Masa Bakti 2019-2020. Tigaraksa, 15 Agustus 2019