SMK PALONG TIMUR

BORANG MAKLUMAT MURID

1. NAMA MURID : ______________________________________________________________

2. TARIKH LAHIR : _______________________________________________________________
3. TEMPAT LAHIR : ______________________________________________________________
4. NO SURAT BERANAK : _________________________________________________________
5. NO I/C : ____________________________________________________________________
6. AGAMA : _________________________________ 7. BANGSA : ________________________

8. ALAMAT TERKINI : ____________________________________________________________

9. KELAB/PERSATUAN : __________________________________________________________

10. BADAN UNIFORM : ___________________________________________________________

11. SUKAN/PERMAINAN : _________________________________________________________

12. RUMAH SUKAN : _____________________________________________________________

13. JAWATAN (CTH : PENGAWAS) : _________________________________________________

MAKLUMAT BAPA /PENJAGA

1. NAMA : ____________________________________________________________________
2. NO I/C : ____________________________________________________________________
3. NO H/P : ___________________________________________________________________
4. PEKERJAAN : ________________________________________________________________
5. ALAMAT TEMPAT KERJA : ______________________________________________________
6. GAJI : ______________________________________________________________________
7.

MAKLUMAT IBU

1. NAMA : ____________________________________________________________________
2. NO I/C : ____________________________________________________________________
3. NO H/P : ___________________________________________________________________
4. PEKERJAAN : ________________________________________________________________
5. ALAMAT TEMPAT KERJA : ______________________________________________________
6. GAJI : ______________________________________________________________________