Nama :
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Alamat :
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Agama :
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Pekerjaan :
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Nama :
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Tempat/Tgl.Lahir :
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Alamat :
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Agama :
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Asal Sekolah :
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No.Telp./Hp :
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Dengan ini mengetahui, menyetujui, dan memberikan izin kepada anak kami tersebut
diatas untuk bekerja di ………………………………………………….. dan akan memberikan
dukungan sepenuhnya .
Demikian surat ini dibuat dengan sadar tanpa paksaan dari pihak manapun untuk
dipergunakan sebagaimana mestinya.
Tasikmalaya, ………………………
Mengetahui,
Orang tua
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