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FORMULIR PENDAFTARAN MENGAJI

MADRASAH DINIYYAH PUTRI


“NURUL HIDAYAH”
Larangan RT.08 RW.03 Krikilan Driyorejo Gresik 61177
Telepon : 085 731 556 589 / 085776708221

No. Induk : .........................................................................................................


Nama Lengkap : .........................................................................................................
Tempat, Tanggal Lahir : .........................................................................................................
Nama Ayah : .........................................................................................................
Nama Ibu : .........................................................................................................
Alamat Lengkap : .........................................................................................................
: .........................................................................................................
Telepon / HP : .........................................................................................................
Putra : Ke...................................Dari........................................Bersaudara.
Pekerjaan Orangtua : .........................................................................................................
Tanggal daftar mengaji : .........................................................................................................

WAKTU MENGEMBALIKAN FORMULIR INI, MOHON DILENGKAPI DENGAN :

FOTO COPY KK : SATU LEMBAR

FOTO COPY AKTE KELAHIRAN : SATU LEMBAR

MEMBAYAR UANG PENDAFTARAN SESUAI YANG DITENTUKAN PENGURUS


MADRASAH

Mengetahui,

Wali Santri / Murid Kepala Madrasah Diniyyah

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