Form.

IK-BK-01/L3
Rev.0
RENCANA PELAKSANAAN LAYANAN/PENDUKUNG
BIMBINGAN DAN KONSELING

Nama Sekolah : SMK Negeri 2 Sampit

Mata Pelajaran/ Kegiatan : Bimbingan Konseling
Kelas/ Semester :
Alokasi Waktu : 2 jp

KOMPONEN
Topik Layanan : ......................................................................................................
Bidang Bimbingan : ......................................................................................................
Fungsi Layanan : ......................................................................................................
Jenis Layanan : ......................................................................................................
Tugas Perkembangan : ......................................................................................................
......................................................................................................
......................................................................................................
Tujuan Layanan : ......................................................................................................
......................................................................................................
......................................................................................................
......................................................................................................
Indikator : ......................................................................................................
......................................................................................................
......................................................................................................
Materi : ......................................................................................................
......................................................................................................
......................................................................................................
......................................................................................................
......................................................................................................
Sumbr, Bahan dan Alat : ......................................................................................................
......................................................................................................
LANGKAH-LANGKAH
Tahap I : ...................................................................................
Permulaan ...................................................................................
...................................................................................
...................................................................................
...................................................................................
Tahap II : ...................................................................................
Peralihan ...................................................................................
...................................................................................
...................................................................................
...................................................................................
Tahap III : ...................................................................................
Kegiatan dan Pembahasan ...................................................................................
...................................................................................
...................................................................................
...................................................................................
Tahap IV : ...................................................................................
Pengakhiran ...................................................................................
...................................................................................
...................................................................................
Rencana Penilaian : ...................................................................................
Catatan Khusus : ...................................................................................
...................................................................................
...................................................................................

Sampit, ...............................
Mengetahui,
Kepala SMK Negeri 2 Sampit Guru BK

Drs. INO ...............................................

NIP.19620603 200003 1 004 Nip..........................................
 Form. IK-BK-01/L2
Rev.0

PEMERINTAH KABUPATEN KOTAWARINGIN

TIMUR
DINAS PENDIDIKAN
SEKOLAH MENENGAH KEJURUAN NEGERI 2
SAMPIT
(KELOMPOK TEKNOLOGI REKAYASA, AGROBISNIS DAN AGROTEKNOLOGI, SENI KERAJINAN DAN
PARIWISATATEKNOLOGI INFORMASI DAN KOMUNIKASI)
Alamat Jalan Sawit Raya Telp.(0531)32089 Fax (0531)32049 Sampit

SURAT PENGANTAR & IZIN BIMBINGAN

Kepada:
Yth. Bapak/Ibu Guru Pengajar
Kelas.................

Mohon diizinkan untuk bimbingan di ruang BK ananda atas nama:

1. .................................................................
2. .................................................................
3. .................................................................
Pada : Hari/Tanggal : ..........................................................
Waktu : ...................WIB s/d ...................WIB

Demikian atas perkenan dan kerjasamanya disampaikan terimakasih

Pembimbing

(..................................................)

Form. IK-BK-01/L2
Rev.0

PEMERINTAH KABUPATEN KOTAWARINGIN TIMUR

DINAS PENDIDIKAN
SEKOLAH MENENGAH KEJURUAN NEGERI 2
SAMPIT
(KELOMPOK TEKNOLOGI REKAYASA, AGROBISNIS DAN AGROTEKNOLOGI, SENI KERAJINAN DAN
PARIWISATATEKNOLOGI INFORMASI DAN KOMUNIKASI)
Alamat Jalan Sawit Raya Telp.(0531)32089 Fax (0531)32049 Sampit

SURAT PENGANTAR & IZIN BIMBINGAN

Kepada:
Yth. Bapak/Ibu Guru Pengajar
Kelas.................

Mohon diizinkan untuk bimbingan di ruang BK ananda atas nama:

1. .................................................................
2. .................................................................
3. .................................................................
Pada : Hari/Tanggal : ..........................................................
Waktu : ...................WIB s/d ...................WIB

Demikian atas perkenan dan kerjasamanya disampaikan terimakasih

Pembimbing

(..................................................)
 Form. Pm 7.5.13/L1
Rev.0
PEMERINTAH KABUPATEN KOTAWARINGIN
TIMUR
DINAS PENDIDIKAN
SEKOLAH MENENGAH KEJURUAN NEGERI 2 SAMPIT
(KELOMPOK TEKNOLOGI REKAYASA, AGROBISNIS DAN AGROTEKNOLOGI, SENI KERAJINAN DAN
PARIWISATATEKNOLOGI INFORMASI DAN KOMUNIKASI)
Alamat Jalan Sawit Raya Telp.(0531)32089 Fax (0531)32049 Sampit

SURAT PENGANTAR PENANGANAN SISWA

Nama Siswa : ........................................................................................

Kelas : .........................................................................................
Keterangan Mengenai Siswa : .........................................................................................
.........................................................................................
.........................................................................................
Permasalahan Siswa : .........................................................................................
.........................................................................................
......................................................................................... ..........
...............................................................................
Penanganan yang sudah dilakukan : .........................................................................................
.........................................................................................
.........................................................................................
Tindak lanjut : .........................................................................................
.........................................................................................
Sampit,
Guru/......

..................................................
NIP.

Form. Pm 7.5.13/L1
Rev.0

PEMERINTAH KABUPATEN KOTAWARINGIN TIMUR

DINAS PENDIDIKAN
SEKOLAH MENENGAH KEJURUAN NEGERI 2 SAMPIT
(KELOMPOK TEKNOLOGI REKAYASA, AGROBISNIS DAN AGROTEKNOLOGI, SENI KERAJINAN DAN
PARIWISATATEKNOLOGI INFORMASI DAN KOMUNIKASI)
Alamat Jalan Sawit Raya Telp.(0531)32089 Fax (0531)32049 Sampit

SURAT PENGANTAR PENANGANAN SISWA

Nama Siswa : ........................................................................................

Kelas : .........................................................................................
Keterangan Mengenai Siswa : .........................................................................................
.........................................................................................
.........................................................................................
Permasalahan Siswa : .........................................................................................
.........................................................................................
......................................................................................... ..........
...............................................................................
Penanganan yang sudah dilakukan : .........................................................................................
.........................................................................................
.........................................................................................
Tindak lanjut : .........................................................................................
.........................................................................................
Sampit,
Guru/......

..................................................
NIP.