Nama : ..........................................................
NIP : ..........................................................
Materi Pembinaan : Pengembangan Bidang Kesiswaan
Tidak
No. Komponen Ada Deskripsi
Ada
A PROGRAM KESISWAAN
B PELAKSANAAN PROGRAM
12 Buku tamu
Catatan : ............................................................................................................................................................
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Tindak lanjut : ...........................................................................................................................................................
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Sleman, …………................2022
Kepala Sekolah Pengawas Sekolah
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NIP……………………… NIP………………………