Mata Pelajaran : ..........................................................................
Kelas / Semester : .......................................................................... Tahun Pelajaran : 2012/2013 Standar Kompetensi : ............................................................................................ ........................................................................................................................ ........................... Kompetensi Dasar : ....................................................................................................................... ........................................................................................................................ 1. Program Remidial a. Sasaran pada siswa nomor : .................................................................................. .............................................................................................................................................. b. Jenis Remidial : ................................................................................. c. Materi : .................................................................................. .............................................................................................................................................. d. Hari/Tanggal Pelaksanaan Remidi Teaching: ....................................................................... e. Hari/Tanggal Pelaksanaan Tes Remidial : ........................................................................... f. Hasil : .................% Tuntas 2. Program Pengayaan a. Sasaran pada siswa nomor : .................................................................................. .............................................................................................................................................. b. Jenis Pengayaan : ................................................................................ c. Materi : ................................................................................ .............................................................................................................................................. d. Hari/Tanggal Pelaksanaan pengayaan : .............................................................................. e. Hasil : ................................................................................. ............................................................................................................................................. Wonosari, Mengetahui : Kepala SMA Muh. Wonosari Guru Mapel : ..........................
Dra. Sri Wahyuni Dwiyanti,M.Pd .................................................