BERITA ACARA PEMANGGILAN ORANG TUA

Bahwa pada hari ini.........................tanggal................................bulan................................

tahun ................................................................pukul..............s/d pukul.............., telah datang orang
tua/wali murid dari :
Nama : ...........................................................................
Kelas : ...........................................................................
No Induk/NISN : ...........................................................................
Alamat : ...........................................................................
Untuk membicarakan masalah perkembangan anak tersebut dia atas, dengan orang tua/wali siswa demi
kelancaran dan perkembangan dalam proses belajar di sekolah.
Hasil yang diperoleh adalah :
1. ......................................................................................................................................................... .........
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2. ........................................................................................................................................................ ..........
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3. ......................................................................................................................................................... .........
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4. ........................................................................................................................................................ ..........
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Demikian berita acara ini dibuat dengan sebenarnya dalam keadaan sadar tanpa tekanan atau
paksaan dari siapapun dan pihak manapun.

Campurdarat, ...........................................
Guru BK Orang tua / Wali siswa

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NIP.

Mengetahui,
Kepala SMA Negeri 1 Campurdarat

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NIP.