FORMULIR PESERTA LOMBA KOMPETENSI SISWA

KABUPATEN SUMEDANG

1. DATA SISWA
NAMA SISWA : .............................................................................
NIS : ................................
ALAMAT : .............................................................................
: .............................................................................
NO.HP : .....................................................
KELAS : .................................
JURUSAN : .............................................................................
ASAL SEKOLAH : .............................................................................
BIDANG LOMBA YANG DIIKUTI : .....................................................

2. DATA PEMBIMBING
NAMA PEMBIMBING : .............................................................................
NO.HP PEMBIMBING : .....................................................

Sumedang, ...............................................2019

Peserta, Mengetahui,
Kepala Sekolah.

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